EIA-910 Monthly Natural Gas Marketer Survey

OMB No. XXXX-XXXX
Expiration Date: 12/31/20XX
Version No.: 20XX.XX
Burden: 2.0 hours

MONTHLY NATURAL GAS MARKETER SURVEY
FORM EIA-910

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
REPORT PERIOD:

Month:

EIA ID NUMBER:

9 1 0

Year:

PART 2. SUBMISSION INFORMATION
Completed form(s) must be filed no later than 30 calendar days
following the end of the report period.

2 0

Form may be submitted using one of the following methods:
Mail to: ATTN: EIA-910

If this is a resubmission, 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

If any Respondent Identification Data has changed since the last report,
enter an "X" in the box:

T

Company Name:
Contact Name:
Phone No.:

-

-

Ext:

Address 1:

[email protected]

Fax:

(202) 586-1076

AF

Secure File Transfer:

Address 2:
City:

Email:

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

State:

Zip:

-

Questions?

Email address:
PART 3. NATURAL GAS SALES

Call: (877) 800 - 5261

Please provide the following information for your residential and commercial customers as defined in the instructions:

2.

4.

Residential

Commercial

To how many end-use customers did you sell natural gas?

How much natural gas did you sell to these customers?
Do not report negative numbers or decimals. You may report in either Thousand
cubic feet (Mcf) or in Therms. Indicate unit of measure by placing and "X" in the
appropriate box.

D

3.

Report State (Enter one of the following States in the box): District of Columbia, Florida,
Georgia, Illinois, Maryland, Michigan, New Jersey, New York, Ohio, Pennsylvania,
Virginia, or West Virginia. Submit a separate form for each State in which your company
has sales to residential and/or commercial end-use customers.

R

1.

For companies reporting sales in all States except Georgia:
What were the gross receipts for the natural gas commodity sold, plus customer
service charges, taxes, and other charges excluding any amount owed to the local
distribution company who transported gas to your customers?

(Number of Customers)

Residential

Commercial
Mcf
Therm

Mcf
Therm

Residential

Commercial

(Dollars)
5.

For companies reporting sales in Georgia:
What were the gross receipts for the natural gas commodity sold, plus customer
service charges, taxes and other charges, including any amount owed to the local
distribution company who transported gas to your customers?

Residential

Commercial

(Dollars)
Comments: Identify any unusual aspects of your reporting month's activity.