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. 351 Original Sheet No. 351 : Effective

TRANSPORTATION REQUEST FORM

(continued)

17. Credit Evaluation - Please provide a copy of Shipper's

most recent quarterly financial statement, most recent

annual report and Form 10-K and a complete list of all

affiliates including parent and subsidiary companies.

18. Is any party to the transaction affiliated with Western

or Southern Union Company?

_____ Yes _____ No

If yes, which party or parties?

__________________________________________________

__________________________________________________

If yes, what is the percentage of affiliation?

____________%

19. Is any of the gas to be transported subject to take-or-

pay crediting?

_____ Yes _____ No

If yes, what percentage of total contract quantity to

be transported is subject to take-or-pay crediting?

____________%