K N Wattenberg Transmission LLC
First Revised Volume No. 1
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Effective Date: 05/22/1998, Docket: RP98-192-000, Status: Effective
Original Sheet No. 117 Original Sheet No. 117 : Effective
TRANSPORTATION SERVICE REQUEST FORM
SHIPPER INFORMATION
Complete Legal name of Shipper: _______________________________________
State of Incorporation: _______________________________________
Taxpayer I.D. Number: _______________________________________
Address: _____________________ For Billing: ___________________
_____________________ ___________________
_____________________ ___________________
Phone: _____________________ Phone: ___________________
Fax: _____________________ Fax: ___________________
For Notices: For Scheduling and Volume
Information:
(Include street address for express service)
Contact Name:_____________________ ___________________
_____________________ ___________________
_____________________ ___________________
Phone: _____________________ Phone: ___________________
Fax: _____________________ Fax: ___________________
Shipper is: ___ Local Distribution ___ Intrastate Pipeline
Company
___ Interstate Pipeline ___ Producer
___ End User ___ Marketer
___ Other (specify) _____________________________________
Name and full title of representative who will execute the written firm
or interruptible transportation service agreement with Transporter (If
signatory person is not an officer, please provide written authorization
for signature).
Name: ____________________________________
Title: ____________________________________
If person requesting service is an agent of Shipper, please provide
proof of authority to act as agent of Shipper and complete the
following: