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Second Revised Sheet No. 113 Second Revised Sheet No. 113 : Superseded

Superseding: First Revised Sheet No. 113

 

 

 

SERVICE REQUEST FORM (Continued)

 

 

 

Viking Gas Transmission Company

Page 7

 

 

 

* 16. If Shipper is purchasing gas, provide the name of producer(s) of the

gas, seller (if different from producer), location (FERC Geographic

Area) of the source(s) of supply, indication of the FERC Geographic

Area associated with the anticipated primary source of supply,

contract quantity, and the effective and termination date(s) of

executed Agreement(s) between Shipper and seller(s):

_____________________________________________

_____________________________________________

_____________________________________________

_____________________________________________

 

 

* 17. If Shipper is selling gas, provide the name of purchaser(s) of the

gas, contract quantity, and the effective and termination date(s) of

executed Agreement(s) between Shipper and purchaser(s):

_____________________________________________

_____________________________________________

_____________________________________________

_____________________________________________

 

18. Credit Evaluation - Please provide a copy of Shipper's most recent

quarterly financial statement, most recent annual report and Form 10K

and a complete list of all affiliates including parent and subsidiary

companies.

 

19. Is requestor affiliated with Viking Gas Transmission Company?

 

______ Yes

______ No

 

If yes, what is the percentage of affiliation? ______%

 

 

* 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.