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THANK YOU FOR USING THE
SOUTHERN UNION WEB REGISTRATION SYSTEM.

We want to make registering on the Web as easy as possible. When you have problems, we want to know so that we can improve the Web Registration process. If you have had a problem, please fill out the form below and provide an explanation of your problem in the space provided.  Be as specific as possible when describing the problem. We will review your problem and try to respond by e-mail or phone within 24 hours.  

* Required Information.

* FirstName:  
* LastName:  
* Area Code  
* First Three Digits of your phone Number:  
* Phone Number:  
Email Address:  

* Date Of Problem:

 
If different from current value enter in mm/dd/yy format.
i.e. - 1 March, 2001 is 03/01/01

* Explain Your Problem:

Please be as specific as possbile.