Viking Gas Transmission Company

Original Volume No. 1

Effective Date: 06/01/1991, Docket: GT91- 25-000, Status: Effective

First Revised Sheet No. 164 First Revised Sheet No. 164 : Superseded

Superseding: Original Sheet No. 164

TRANSPORTATION SERVICE REQUEST FORM (Continued)

Viking Gas Transmission Company

Page 5

9. Date service is proposed to commence:

_____________________________________

l0. Term of service:

_____________________________________

11. If additional or new facilities are required to receive or deliver gas for the

transportation service requested herein, please provide description of facilities

required, location, and requested in-service date;

_____________________________________________________________________________________

and, if the transportation service to be provided using the new facilities is to a

customer that is located in the service area of a local distribution company, please

specify the name of the local distribution company.

12. The maximum daily quantity to be transported is ___________ Dth. The estimated total

quantity of gas to be transported during the requested term of service is ___________

Dth.

13. For firm transportation only, the name and description of Point(s) of Receipt into

Viking's system and the maximum daily quantities expressed in Dth of gas to be delivered

by Shipper for each point:

_____________________________________________________________________________________

(The sum of the maximum daily quantities above must equal the maximum daily quantity set

forth in No. 12 above.)