Natural Gas Pipeline Company Of America

Seventh Revised Volume No. 1

Effective Date: 04/18/2008, Docket: RP08-319-000, Status: Effective

Original Sheet No. 624 Original Sheet No. 624 : Pending

RO No.: .......

LPS REQUEST ORDER FORM

DATED ..........

Shipper: ........................................... Type of Service: Park ........ Loan ........

Initiation Point Name(s) and PIN(s):................ MAQ RO: ...................................Dth)

Completion Point Name(s) and PIN(s):................ Minimum Aggregate Quantity:....................

Term: Start .................. End ............... LPS Agreement #: ..............................

Schedule:

Date(s) Service to be Provided Daily Quantity (Dth)

(May Reflect a Range of Dates) (May Reflect a Range of Volumes)

------------------------------ ---------------------------------------------------------------------

Park or Loan Payback Loan or Park Withdrawal

From Through Minimum Maximum Minimum Maximum

------------- ------------- -------------- -------------- ------------- --------------

............. ............. .............. .............. ............. ..............

Rates: Rates may vary based on volume, time period, etc., as set out in the Pro Forma Service Agreement

Initial Fee: ..........................................................................................

Completion Fee: .......................................................................................

Park/Loan Balance Fee: ................................................................................

Park or Loan Payback = volumes which Natural RECEIVES from Shipper.

Loan or Park Withdrawal = volumes which Natural DELIVERS to Shipper.

Service will be ON BEHALF OF:

...... Shipper or

...... Other: ....................................................., a ..............................

SHIPPER'S CONTACT AND ADDRESS

......................................................................................................

Phone: .......................................... Fax: ...........................................

Other Conditions (if any): ...........................................................................

Agreed to by:

NATURAL SHIPPER

/s/: ............................................ /s/: ............................................

NAME: ........................................... NAME: ...........................................

TITLE: .......................................... TITLE: ..........................................