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Date:

______________

FINAL BILL DISPUTE INSTRUCTIONS

Recently, you contacted us requesting a review of a dispute you may have with National Grid. In an effort to facilitate the resolution of your dispute, please complete the applicable portion of this form.

Collection efforts on this disputed account will be suspended for up to fifteen (15) days. However, if we do not receive the necessary information from you, or your information is not complete within the fifteen (15) days, collection efforts will resume on the disputed amount. If we do not hear from you within the fifteen (15) days, we will assume that you do not wish to pursue this matter, and will consider your dispute inquiry closed.

National Grid will notify you in writing of the final results of your dispute.

ALL QUESTIONS PERTAINING TO YOUR DISPUTE MUST BE ANSWERED AND ALL DOCUMENTS THAT SUPPORT YOUR CLAIM MUST BE ATTACHED TO THIS FORM.

Account number:

_____________________________________________________________________

Amount in dispute: $

___________________________________________________________________

Is this disputed information listed on your credit report?

Yes F

No F

Unknown F

Your name:

__________________________________________________________________________

Current address:

______________________________________________________________________

Current mailing address, if different:

_______________________________________________________

How long have you been at this address?

__________________________________________________

Current phone number:

_________________________________________________________________

Your social security number: ____________________________________________________________ (While not required, if you do not provide your social security number, you must submit two (2) alternate forms of identification. (See Page 5)

Previous address:

_____________________________________________________________________

From:

To:

______________________

_______________________

Previous address:

_____________________________________________________________________

From:

To:

______________________

_______________________

1 FINAL+BILL+DISPUTE+FORM+KEYSPAN+(3)[1].DOC

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