Kinder Morgan Interstate Gas Transmission LLC

Second Revised Volume No. 1-C

Effective Date: 12/28/1999, Docket: GT00- 19-000, Status: Effective

Original Sheet No. 28 Original Sheet No. 28 : Superseded

BUFFALO WALLOW TRANSPORTATION SERVICE REQUEST FORM

SHIPPER INFORMATION

Complete Legal Name of Shipper: ____________________________________________

____________________________________________________________________________

State of Incorporation: _________________________________________________

Taxpayer I.D. No.________________________________________________________

Address: ____________________ For Billing: ______________________

____________________ ______________________

Phone: ____________________ Phone: ______________________

Fax: ____________________ Fax: ______________________

For Notices: For Scheduling and Volume Information:

(include street address for express service)

Contact Name:

_______________________ ______________________

Phone: _______________________ Phone: ______________________

Fax: _______________________ Fax: ______________________

Shipper is: ___ Local Distribution Company ___ Intrastate Pipeline

___ Interstate Pipeline ___ Producer

___ End User ___ Marketer

___ Other (specify) ______________________________________

Name and full title of representative who will execute the written firm

or interruptible transportation service agreement with Transporter (If

signatory person is not an officer, please provide written authorization

for signature.)

Name: ________________________________________________

Title: ________________________________________________