Tennessee Gas Pipeline Company

FIFTH REVISED VOLUME NO. 1

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Effective Date: 10/01/2009, Docket: RP09-998-000, Status: Effective

First Revised Sheet No. 513A First Revised Sheet No. 513A

Superseding: Original Sheet No. 513A

SERVICE REQUEST FORM

(PARK AND LOAN)

Tennessee Gas Pipeline Company

P. O. Box 2511

Houston, Texas 77252-2511

Attention: Director of Transportation Services

Re: ________ New Service

or

________ Modification of Existing Service

(Description of existing service to be modified:

________________________________________________

________________________________________________

________________________________________________

Gentlemen:

____________________________(Shipper) hereby requests Park and/or Loan service(s) from

Tennessee Gas Pipeline Company (Tennessee) and concurrently provides the following

information in connection with this request:

1. Complete legal name of Shipper:

_______________________________________________________________________________

2. Type of legal entity and state of incorporation:

_______________________________________________________________________________

_______________________________________________________________________________

3. Type of company:

_______________ Local Distribution Company

_______________ Intrastate Pipeline

_______________ Interstate Pipeline

_______________ Producer

_______________ End-User

_______________ Marketer

_______________ Broker

_______________ Pipeline Sales Operating Unit

_______________ Other (fill in)