Texas Gas Transmission Corporation

First Revised Volume No. 2-A

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Effective Date: 12/01/1991, Docket: RP92- 20-000, Status: Effective

First Revised Sheet No. 179 First Revised Sheet No. 179 : Effective

Superseding: Original Sheet No. 179

TEXAS GAS TRANSMISSION CORPORATION

TRANSPORTATION REQUEST FORM

Section 250.16(b)(2)

(Continued)

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FOR TEXAS GAS USE ONLY

Texas Gas Log Number: ___________________

Date Request Received: ___________________

Date Requester Notified

of Incomplete Status: ___________________

Date Request Accepted

as Complete and Valid: ___________________

Distance transported

mileage

(farthest point-to-point) ___________________

Related Docket Number: ___________________

Credit Application: ___________________

T & E Rep: ___________________