Ozark Gas Transmission System

First Revised Volume No. 1

Effective Date: 10/01/1993, Docket: RS92- 72-003, Status: Effective

First Revised Sheet No. 29 First Revised Sheet No. 29 : Superseded

Superseding: Original Sheet No. 29

TRANSPORTATION SERVICE REQUEST FORM

(Continued)

4. State the name, address, telephone number and

facsimile number of a twenty-four (24) hour

contact person for purposes of dispatching gas to

and from delivery and receipt points. State

whether this person is an employee of Shipper,

or, if not, state relationship to Shipper:

__________________________

5. Type of Service Requested:

Firm Service (Rate Schedule FTS)

Interruptible Service (Rate Schedule ITS)

Subpart B (Section 311)

Subpart G

If transportation is pursuant to NGPA Section

311, designate the "on behalf of" party:

_____________________________________________

("On behalf of" letter, if applicable, must be

attached to a completed request).

*6. If Shipper is requesting service be performed by

Ozark for shipper acting as agent for another

entity, please specify the full legal name of

such entity.

*7. The intended use of the gas is:

____________ system supply

____________ end use by industry or commerce

____________ other (fill in)

and, if the gas is for other than system supply,

please provide the full legal name of the

ultimate consumer, and the location (i.e., state)

of the ultimate delivery points of the gas to be

transported (i.e., if ultimate consumer is an end

user, location(s) of plant(s) where gas is to be

consumed), and the local distribution company of

which the ultimate consumer is the customer: