Mississippi River Transmission Corp.

Original Volume No. 1-A

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Effective Date: 04/20/1991, Docket: RP91-121-000, Status: Effective

Second Revised Sheet No. 76 Second Revised Sheet No. 76 : Effective

Superseding: First Revised Sheet No. 76

FORM OF REQUEST FOR TRANSPORTATION

(Continued)

 

III. REQUESTED FORM OF SERVICE

 

 

3. Shipper is: a) Interstated) End User g) Other (Specify)

b) Intrastatee) Producer

c) LDCf) Marketer/Broker

 

Shipper acknowledges by its signature that it is willing to abide by the terms

of Transporter's Original Volume No. 1-A Tariff.

 

Shipper, by its signature, certifies to Transporter (1) that it has good title

to the gas or a current contractual right to acquire title and (2) that it has

entered into all necessary arrangements to assure that upstream and

downstream transportation will be in place prior to the commencement of

the requested service.

 

Shipper also certifies that the information herein is complete and accurate

to the best of Shipper's knowledge, information and belief.

 

Shipper: Requestor

By: By:

Signature: Signature:

Title: Title:

Date: Date: