Production Release - Drop of Existing Meter(s)

Required Fields are marked with an asterisk (*).

*Applicable Pipeline System:	--Select-- Benezette Brenton Equitrans Gathering Goodwin KA Madison Kentucky Madison Three Rivers
*Requestor	--Select-- Current Shipper Producer
Effective Date of Transaction
Request must be 30 days in advance of the drop effective date.
Effective Date

Current Shipper Information
*Company Name:
*Contact Person:
*Phone Number: [(999)999-9999 or 999-999-9999]
*Email:
*Contract Number:

Producer Company Information
*Company Name:
*Contact Person:
*Phone Number: [(999)999-9999 or 999-999-9999]
*Email:
Check box only if producer does not have an e-mail address. Go to the Meter Add, Drop, or Transfer Application Instructions for directions regarding completion of request for producers without an e-mail address.

*POI #	*Farm Name	*Estimated Dth/Day
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I acknowledge that my producer is required to notify the Transportation & Exchange department via e-mail within 14 days. I also understand that the meter drop transaction will not be completed until the form is completed and sent to the T&E group.