T.W. Phillips Pipeline Corp.

Original Volume No. 1

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Effective Date: 01/01/2010, Docket: RP10-141-000, Status: Effective

Original Sheet No. 118 Original Sheet No. 118

 

Exhibit R-1

 

Replacement Shipper (contact person with address, including email, phone and fax):

 

____________________________________________________________

____________________________________________________________

____________________________________________________________

____________________________________________________________

 

 

Signature:

____________________________________________________________

For:________________________________________________________

(Replacement Shipper)

 

 

Name:_______________________________________________________

 

Title:______________________________________________________

 

Date:_______________________________________________________