National Grid - Five Year Statement Request Form

Five Year Statement Request Form
We will provide a copy of the Five Year Statement, 2008-2012 and a password to access the full document on our website, to those who have business and regulatory interests that may benefit from this information. However, due to security concerns, we will screen all requests to ensure that only appropriate persons receive this information.

	( = required information)

Name:
Title:
Company, organization or governmental department:
Which role or organization describes you?	Select the first one that fits:
Address:
Address 2:	Note: We cannot accept PO boxes
City:
State/Province:	Zip Code:
Country:
Telephone:
Email Address:
Please select your Username (up to 10 characters):

Please read this carefully: I understand that National Grid's Five Year Statement (FYS) contains information that may be considered sensitive from a security perspective. I will not copy or redistribute any portion of the FYS, and will keep my copy in a secure location, limiting access to trusted persons within my organization who will utilize it solely for legitimate purposes. I will safeguard the website and document passwords assigned to me and not disclose them to anyone. I will limit prints made of FYS material on the website to my personal use and will handle them with the same concern for security as the printed booklet provided by National Grid. I will not include any portion of the FYS in regulatory filings with FERC or any other governmental body, unless it is mandatory that I do so, and I will alert National Grid of any situations in which I am required to submit FYS materials. When I no longer need the FYS materials, I will either return them to National Grid, or destroy them through shredding or incineration.
I agree:	I disagree:

The information provided here will be used only in relation to the Five Year Statement and will not be disclosed to other parties.