Ozark Gas Transmission System

First Revised Volume No. 1

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

First Revised Sheet No. 30 First Revised Sheet No. 30 : Superseded

Superseding: Original Sheet No. 30

TRANSPORTATION SERVICE REQUEST FORM

(Continued)

8. Date service is proposed to commence:

Date service is proposed to terminate:

9. If additional or new facilities are required to

receive or deliver gas for the transportation

service requested herein, please provide descrip-

tion of facilities required, location, and

requested in-service date.

10. The Maximum Daily Quantity to be transported is

__________MMBtu and ___________ Mcf. The

estimated total quantity of gas to be transported

during the requested term of service is

__________ MMBtu and __________ Mcf.

11. Name and description of Receipt Point(s) into

Ozark's system and the maximum daily quantities

expressed in MMBtu and Mcf's of gas to be

delivered by Shipper for each point. Shipper may

indicate Master Receipt Point list.

(the sum of the maximum quantities above must

equal the maximum daily quantity in #10 above.)

12. Name and description of Delivery Point where

Ozark will redeliver the gas:

13. The names of those entities delivering gas into

Ozark's system and the names of those entities

taking gas off Ozark's system:

Ozark Receipt Point(s) Name/Delivering Entity

______________________ ______________________

Ozark Delivery Point(s) Name/Taking Entity

_______________________ ______________________