Ozark Gas Transmission, L. L. C.

Original Volume No. 1

 Contents / Previous / Next / Main Tariff Index

Effective Date: 09/01/2008, Docket: RP08-458-001, Status: Pending

Third Revised Sheet No. 97 Third Revised Sheet No. 97

Superseding: Second Revised Sheet No. 97

GENERAL TERMS AND CONDITIONS (continued)

18. SERVICE REQUEST FORM

Ozark Gas Transmission, L.L.C. Facsimile: (918) 398-2165

1437 South Boulder Ave. Telephone: (918) 496-4968

Suite 1501

Tulsa, OK 74119

Attention: Amy Nance

Re: _____ New Service _____Firm Transportation Service

or _____Firm Storage Service

_____ Modification _____No-Notice Service

of Existing Service _____Interruptible Transportation

Service

_____Park and Loan Service

(Description of existing service to be modified:

Contract No. _______________________

__________________________________

__________________________________)

Gentlemen:

______________________ ("Shipper") hereby requests

transportation service from Ozark Gas Transmission, L.L.C.

("Ozark") and concurrently provides the following information in

connection with this request:

1. Complete legal name and principal place of business of

Shipper:

2. Type of company:

___________ Local Distribution Company

___________ Intrastate Pipeline

___________ Interstate Pipeline

___________ Producer

___________ End-User

___________ Marketer

___________ Broker

___________ Other (fill in)