K N Interstate Gas Transmission Co.

Second Revised Volume No. 1-A

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Effective Date: 11/01/1994, Docket: RP94-397-000, Status: Effective

First Revised Sheet No. 107 First Revised Sheet No. 107 : Superseded

Superseding: Original Sheet No. 107

STORAGE SERVICES REQUEST FORM

 

 

K N INTERSTATE GAS TRANSMISSION CO.

 

 

SHIPPER INFORMATION

 

Complete Legal Name of Shipper: ____________________________________

State of Incorporation: _____________________________

 

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 Company ___ Intrastate Pipeline

___ Interstate Pipeline ___ Producer

___ End User ___ Marketer

___ Other (specify) _______________________________________

 

Name and full title of representative who will execute the written firm or

interruptible storage 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: