Wyoming Interstate Company, Ltd.

Second Revised Volume No. 2

 Contents / Previous / Next / Main Tariff Index

Effective Date: 04/12/2010, Docket: RP10-491-000, Status: Effective

Fifth Revised Sheet No. 49A Fifth Revised Sheet No. 49A

Superseding: Fourth Revised Sheet No. 49A

GENERAL TERMS AND CONDITIONS

(Continued)

4. REQUESTS FOR SERVICES (Continued)

4.7 Transportation Service Request Form

REQUEST FOR

NEW

TRANSPORTATION SERVICE

1. SHIPPER: TRANSPORTER:

Legal Company Name:__________________ Wyoming Interstate Company, L.L.C.

Street Address:______________ Zip:_____P. O. Box 1087

P.O. Box: ___________________Zip:_____Colorado Springs, CO 80944

City: ______________________State:_____Attn: Vice President, Marketing

Attn: ___________________ c/o Customer Service

Telephone: ______________ Representative

Fax: ____________________ Telephone: (719) 520-4465

Dispatcher: _____________ Telecopier: (719) 520-4878

Dun & Bradstreet (DUNS) Number: ______ Verification: (719) 520-4371

Billing Address (To Whom Invoices Should Be Addressed):

Legal Company Name: _________________________

Street Address: ___________________Zip: ____________

P.O. Box: ___________________Zip: ____________

City: __________________ State: _______________

Attn: __________________

Telephone: _____________

Fax: __________________

Would you like your invoice faxed? _______

Requestor (If Different From Shipper):

_________________________

_________________________

_________________________

Attn: ___________________

Telephone: ______________

2. SHIPPER TYPE: ___ LDC ___ Interstate Pipeline

___ Intrastate Pipeline ___ End User

___ Producer

___ Marketer/Broker

___ Other (Please Specify)