One-Time Burden for Form 2A under RM07-9-004

Page 521d.

Name of Respondent

This Report is: (1)  An Original (2)  A Resubmission

Date of Report (Mo, Da, Yr) / /

Year/Period of Report End of Year/Qtr

Shipper Supplied Gas for the Current Quarter (continued)

Amount Collected (Dollars)

Volume (in Dth) Not Collected

Month 1 Discounted Rate Amount (f)

Month 1 Negotiated Rate Amount (g)

Month 1 Recourse Rate Amount (h)

Month 1 Total Amount (i)

Month 1 Waived Dth (j)

Month 1 Discounted Dth (k)

Month 1 Negotiated Dth (l)

Month 1 Total Dth (m)

Month 1 Account(s) Debited (n)

Month 1 Account(s) Credited (o)

FERC FORM NO. 2 (REVISED 12-10) Page 521d

FERC FORM NO. 2-A (REVISED 12-10)

FERC FORM NO. 3-Q (REVISED 12-10)