EIA-910 Monthly Natural Gas Marketer Survey

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 8.0 or later or Mozilla Firefox 5.0 or later. Send your surveys using this secure method at: https://signon.eia.gov/upload/noticeoog.jsp

OMB No. 1905-0175

Expiration Date: xx/xx/xxxx

Version No.: xxxx.xx

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

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:

9

1

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:

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

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

enter an "X" in the box:

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 SALES

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

1.

Report State (Enter one of the following States in the box):

Georgia, New York,

or Ohio. Submit a separate form for each State in which your company has sales

residential and/or commercial end-use customers.

Residential

Commercial

2.

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

(Number of Customers)

3.

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 an "X" in the appropriate box.

Residential

Commercial

Mcf

Mcf

Therm

Therm

4.

For companies reporting sales in all States except Georgia:

Residential

Commercial

(Dollars)

5.

Residential

Commercial

(Dollars)