Tariff
TWP Pipeline LLC
FERC GAS TARIFF
SECOND REVISED VOLUME NO. 1
SECTION 8.1
FORM OF TRANSPORTATION SERVICE REQUEST
VERSION 3.0.0
TWP Pipeline LLC FORM OF TRANSPORTATION SERVICE REQUESTSHIPPER INFORMATION Complete legal name of Shipper:______________________________________________ State of Incorporation: Address:_____________________________ Billing _____________________________ _____________________________ Address:_____________________________ _____________________________ _____________________________ Phone: _____________________________ Phone: _____________________________ Contact information for Notices: Contact information for scheduling and volume information: Name: ________________________________ ________________________________ Address:________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ ________________________________ Phone: ________________________________ ________________________________ E-mail: ________________________________ ________________________________ Shipper is a (n) _____ Local Distribution Company _____ Intrastate Pipeline _____ Interstate Pipeline _____ Producer _____ End User _____ Marketer _____ Other (Specify)____________________________________________ Name and full title of Officer, or other authorized person(s) who will execute the written transportation 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: Legal Name of Principal: _____________________________________ which is a (n) _____ Local Distribution Company _____ Intrastate Pipeline _____ Interstate Pipeline _____ Producer _____ End User _____ Marketer _____ Other (Specify)____________________________________________