Form Mcf 1 - Application For Natural Gas Distribution Company

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MCF 1
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Rev. 3/10
P .O. Box 530
Columbus, OH 43216-0530
Application for Natural Gas Distribution Company
Ohio Revised Code Section 5727.93(A)
Name
FEIN
Address
Street address
City
State
ZIP code
Mailing address (if different from above)
Contact person
Telephone number
Fax number
E-mail address
Number of customers
If the number of customers is less than 70,000, do you elect to aggregate the natural gas distribution to all customers in Ohio
to determine the tax? [Refer to Ohio Revised Code section 5727.811(C).]
Yes
No
This registration, if approved, will remain in effect until canceled by the registrant or revoked by the tax commissioner.
Signature
Title
Date
I declare under penalties of perjury that the above statements have been examined by me and to the best of my knowledge
and belief are true, complete and correct.

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