Western Gas Interstate Company

Fourth Revised Volume No. 1

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Effective Date: 04/01/1996, Docket: CP96- 81-006, Status: Effective

Original Sheet No. 345 Original Sheet No. 345 : Effective

TRANSPORTATION REQUEST FORM

(continued)

4. Name of Shipper's contact, address and telephone number

through which correspondence for the following should

be directed:

Contact for Request:

______________________________________

______________________________________

______________________________________

Contact for Notices:

______________________________________

______________________________________

______________________________________

Contact for Invoices:

______________________________________

______________________________________

______________________________________