For Official Use Date Received: Ref No.: Application Form for allocation direction under section 38a gas Act




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Maxwell Road, Tower Block

MND Complex, #13-01

Singapore 069 110

ccs_complaints@ccs.gov.sg



For Official Use

Date Received:

Ref No.:


Application Form

for allocation direction under section 38A Gas Act





A. Particulars of Applicant

Name of person / organisation making the application (Applicant):

Address:



Postal Code:





Contact No./Fax No.:


Email address:


Name of Officer / Representative

Contact particulars of Officer / Representative

Tel:

Email address:

Fax:


B. Particulars of Existing User(s) of the Offshore Gas Pipeline



No

Full Name

Address

Contact Particulars

(Tel/Fax/Email, if available)



























































C. Particulars of Pipeline Operator of the Offshore Gas Pipeline



No

Full Name

Address

Contact Particulars

(Tel/Fax/Email)
















D. Description of Applicant’s efforts and failure to enter into gas allocation arrangements with

Existing Users of Offshore Gas Pipeline



Please list all evidence supporting your application and attach all such relevant documents to this application form:

(e.g. agreements, minutes of meetings, business documents, circulars, correspondence, notes of telephone conversations etc.

EMA accepts printed copies or scanned copies on CD-ROM


E. Proposed allocation agreement or basis of allocation


Please summarise the allocation terms or basis of allocation which the Applicant considers to be reasonable if imposed on all users of the Offshore Gas Pipeline.

Please attach a copy of the draft allocation agreement to this application form.


F. Details of other parties who may be able to provide further information regarding this application



Name of party:



Organisation:

Contact Details:


Name of party:



Organisation:

Contact Details:


Name of party:



Organisation:

Contact Details:


H. Declaration


We certify that the above information is true, correct and made in all good faith.


Name:

Designation:

Signature (for and on behalf of Applicant):



Date:





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