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

OMB No. 1905-0175
Expiration Date: 02/28/2015
Version No.: 2012.01
MONTHLY REPORT OF NATURAL GAS PURCHASES AND DELIVERIES TO CONSUMERS Burden: 3.5 hours
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 2. SUBMISSION INFORMATION

PART 1. RESPONDENT IDENTIFICATION DATA
REPORT PERIOD:

Month:

EIA ID NUMBER:

8 5 7

Year:

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

2 0

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

Form may be submitted using one of the following methods:

Mail to:

ATTN: EIA-857
U. S. Department of Energy
Oil & Gas Survey
Ben Franklin Station
P.O. Box 279
Washington, DC 20044-0279

Email:

[email protected]

Fax No.:

Fax:

(202) 586-1076

Address 1:

Secure File Transfer:

enter an "X" in the box:
Company Name:
Contact Name:
Ext:

Phone No.:

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

Address 2:
City:

State:

-

Zip:

Questions?

Email address:

Call: (877) 800-5261

PART 3. NATURAL GAS PURCHASES AND DELIVERIES TO CONSUMERS BASED ON CALENDAR MONTH RECORDS
Volume
(Mcf @ 14.73 psia-60 oF)
1.0
Purchased gas received in distribution service area (Citygate)
……………
Total operational sendout to consumers of gas owned and not owned

………

Cost
(Including taxes)

2.0

Gas used in operations, including space heat, pipeline distribution or
storage compressor use, and line loss……………………………………

2.1

PART 4. NATURAL GAS DELIVERIES TO CONSUMERS BASED ON FINANCIAL RECORDS
Number of
Deliveries of natural gas that you do own to consumers within the
Customers
report State
3.0
Residential ………………………………………………………….
4.0
…………..
Commercial (excluding company use and vehicle fuel)
4.1
Vehicle Fuel ………………………………………………………
5.0
………………………………………………………….
Industrial
Electric Power ………………………………………………………
6.0
7.0
Other (not included in above categories)

Volume
(Mcf @ 14.73 psia-60 oF)

Revenue
(Including taxes)

Volume
(Mcf @ 14.73 psia-60 oF)

Revenue
(Including taxes)

(Specify Type)

Number of
Customers

Deliveries of natural gas that you do not own to consumers within the
report State
Residential ………………………………………………………….
…………………………………
Commercial (excluding vehicle fuel)
Vehicle Fuel ………………………………………………………..
………………………………………………………….
Industrial
Electric Power ………………………………………………………
Other (not included in above categories)

8.0
9.0
9.1
10.0
11.0
12.0

(Specify type)

Total of all deliveries (Lines 3.0 through 12.0)

……………………………

13.0

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.)