Viking Gas Transmission Company

First Revised Volume No. 1

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Effective Date: 01/01/2000, Docket: RP00-110-000, Status: Effective

Second Revised Sheet No. 110 Second Revised Sheet No. 110 : Superseded

Superseding: First Revised Sheet No. 110

SERVICE REQUEST FORM (Continued)

Viking Gas Transmission Company

Page 4

If DOE authorization has been applied for, please state:

i. Date of Application _________________________________

ii. Volume to be Imported _________________________________

iii. Current Status _________________________________

* 7. If Shipper is requesting service be performed by Viking for Shipper

acting as agent for another entity, please specify the full legal

name of such entity.

_______________________________________________________________

_______________________________________________________________

8. a) Location (i.e. state(s)) of the ultimate delivery point of gas

to be transported:

_______________________________________________________________

b) Location (i.e. state(s)) of the original source of the gas to

be transported:

_______________________________________________________________

*c) The intended use of the gas is:

______________ system supply for _________________

______________ end use by industry or commerce

______________ other (fill in)

and, if the gas is for other than system supply, please provide the

full legal name of the ultimate consumer:

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

* This information is not required at the time of the request, but is

required at the time Shipper executes the Gas Transportation Agreement

or Gas Park and Loan Agreement.