National Fuel Gas Supply Corporation

Third Revised Volume No. 1

Effective Date: 01/06/1995, Docket: RP95- 83-000, Status: Effective

First Revised Sheet No. 254 First Revised Sheet No. 254 : Superseded

Superseding: Original Sheet No. 254

8. Intended use of gas is:

__ system supply

__ end use by industry or commerce

__ other (fill in) ______________________________

9. Who will own the gas while on National's system?

__ Shipper

__ Other (fill in) Name: ____________________________

Address: ____________________________

Contact: ____________________________

Telephone: ____________________________

National reserves the right to require proof that an

agency agreement exists between the Shipper and the actual

owner of the gas while it is on National's system

10. Sources of gas: ______________________________________________

_______________________________________________________________

(Use state abbreviations)

11. Location(s) of consumption: ____________________________________

________________________________________________________________

(Use state abbreviations)

12. Date service is proposed to commence: __________________________

13. Term of service: ____ years ____ months (maximum 20 years)

14. Are additional or new facilities required to receive or

deliver gas for the transportation service requested herein?

__ no __ yes. If yes describe: __________________________

____________________________________________________________

15. The maximum daily quantity to be transported or wheeled is

_____ Dth.

The maximum daily quantity to be injected into storage or parked

is _____ Dth.

The maximum daily quantity to be withdrawn from storage is

_____ Dth.

The maximum storage quantity requested is _______ Dth.

The maximum advance quantity is _______ Dth.

(FILL IN WHICHEVER ARE APPLICABLE)