Form EIA-857 Monthly Report of Natural Gas Purchases and Deliveries t

This form may be submitted to the EIA by mail, fax, e-mail, or secure file transfer. Should you choose to submit your data via e-mail, we must advise you that e-mail is an insecure means of transmission because the data are not encrypted, and there is some possibility that your data could be compromised. You can also send your Excel files to EIA using a secure method of transmission: HTTPS. This is an industry standard method to send information over the web using secure, encrypted processes. (It is the same method that commercial companies communicate with customers when transacting business on the web.) To use this service, we recommend the use of Microsoft Internet Explorer 5.5 or later or Netscape 4.77 or later. Send your surveys using this secure method at: https://signon.eia.doe.gov/upload/noticeoog.jsp

OMB No. 1905-0175

Expiration Date: 12/31/2011

Version No.: 2009.01

MONTHLY REPORT OF NATURAL GAS PURCHASES AND DELIVERIES TO CONSUMERS

FORM EIA-857

This report is mandatory under the Federal Energy Administration Act of 1974 (Public Law 93-275). Failure to comply may result in criminal fines, civil penalties and other sanctions as provided by law. For the sanctions and the provisions concerning the confidentiality of information submitted on this form, see instructions. Title 18 USC 1001 makes it a criminal offense for any person knowingly and willingly to make to any Agency or Department of the United States any false, fictitious, or fraudulent statements as to any matter within its jurisdiction.

PART 1. RESPONDENT IDENTIFICATION DATA

PART 2. SUBMISSION INFORMATION

Completed form(s) must be filed no later than 30 calendar days following the end of the report period.

REPORT PERIOD:

Month:

Year:

2

0

EIA ID NUMBER:

8

5

7

Form may be submitted using one of the following methods:

If this is a resubmission, enter an "X" in the box:

If any Respondent Identification Data has changed since the last report,

Mail to:

ATTN: EIA-857

enter an "X" in the box:

U. S. Department of Energy Oil & Gas Survey Ben Franklin Station P.O. Box 279 Washington, DC 20044-0279

Company Name:

Contact Name:

Phone No.:

Ext:

Email:

[email protected]

Fax No.:

Fax:

(202) 586-1076

Address 1:

Secure File Transfer:

Address 2:

https://signon.eia.doe.gov/upload/noticeoog.jsp

City:

State:

Zip:

-

Email address:

Questions?

Call:

(877) 800-5261

PART 3. NATURAL GAS PURCHASES AND DELIVERIES TO CONSUMERS

Volume

Cost

(Mcf @ 14.73 psia-60oF)

(Including taxes)

Purchased Gas Received in Distribution Service Area (City Gate)

……….

1

Total sendout of gas owned and not owned (may not be total of lines 3-12 due to billing cycles)

2

Deliveries of natural gas that you do own to end-use consumers within the

Number of Customers

Volume

Revenue

report State according to the most recent month of billing

(Mcf @ 14.73 psia-60oF)

(Including taxes)

Residential

………………………………………………………….

3

Commercial

………………………………………………………….

4

Industrial

………………………………………………………….

5

Electric Power

………………………………………………………

6

Other (not included in above categories)

7

(Specify Type)

Deliveries of natural gas that you do not own to end-use consumers within

Number of Customers

Volume

Revenue

report State according to the most recent month of billing

(Mcf @ 14.73 psia-60oF)

(Including taxes)

Residential

………………………………………………………….

8

Commercial

………………………………………………………….

9

Industrial

………………………………………………………….

10

Electric Power

………………………………………………………

11

Other (not included in above categories)

12

(Specify Type)

Heat content of gas delivered to consumers (Btu/cubic ft.):

Comments: Identify any unusual aspects of your reporting month's activity. (To separate one comment from another, press ALT + ENTER.)