Tuscarora Gas Transmission Company

Original Volume No. 1

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Effective Date: 12/01/1995, Docket: CP93-685-003, Status: Effective

Original Sheet No. 133 Original Sheet No. 133 : Effective

SERVICE REQUEST FORM FOR

TUSCARORA GAS TRANSMISSION COMPANY

7. Contact Person for Request:_______________________________________

Mailing Address:__________________________________________________

__________________________________________________

Street Address:___________________________________________________

___________________________________________________

Phone:____________________________________________________________

Telecopy No:______________________________________________________

8. Twenty-four hour contact person for purposes of dispatching gas to

and from receipt and delivery points: ____________________________

__________________________________________________________________

Mailing Address:__________________________________________________

__________________________________________________________________

Street Address:___________________________________________________

Phone:____________________________________________________________

Telecopy No:______________________________________________________

9. Shipper Certification:

Shipper hereby certifies that Shipper has title or current contractual right

to acquire title to the gas supply for which transportation service is

requested, and that Shipper has or will enter into all contractual

arrangements necessary to ensure that all upstream and downstream

transportation is in place prior to the date on which service is requested to

commence.

____________________________________