Southern LNG Inc.

Original Volume No. 1

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Effective Date: 12/01/2001, Docket: CP99-582-004, Status: Effective

Original Sheet No. 124 Original Sheet No. 124 : Effective

 

GENERAL TERMS AND CONDITIONS

(Continued)

 

APPENDIX E Page ____ of ____

SOUTHERN LNG INC.

CUSTOMER SERVICES DEPARTMENT

LNG BALANCE TRANSFER FORM

 

Customer: ___________________________________ Contract Number:_____________

 

Effective: ______________________

Month Day Year

 

QUANTITIES TO BE TRANSFERRED INTO CUSTOMER'S LNG BALANCE ACCOUNT

 

Transfer into

Storage Contract No.: Quantity to Transfer - Dth

___________________________________ _________________________________

___________________________________ _________________________________

 

TOTAL _________________________________

 

QUANTITIES TO BE TRANSFERRED FROM CUSTOMER'S LNG BALANCE ACCOUNT

 

Transfer into

Storage Contract No.: Quantity to Transfer- Dth

___________________________________ _________________________________

___________________________________ _________________________________

 

TOTAL _________________________________

 

Comments:_____________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

______________________________________________________________________________

 

Signed: _________________________________________

Name: ___________________________________________

Company: ________________________________________

Telephone No.: __________________________________