[ACCESS APPLICATION FORM TO BE REPRODUCED ON PAPER WITH THE APPLICANT'S LETTER HEAD]

Confidential - Courtesy English Translation (not binding – only the Italian version is binding)

OLT OFFSHORE LNG TOSCANA S.p.A.

Via D’Alesio, 2

57126 Livorno

Italy

For the attention of: Alberto Ton

With reference to the Allocation of Delivery Slots during the Gas Year pursuant to Clause 2.1.9 of Access Code, the undersigned ………………………………., born on…../…../….., tax code…………………………., resident in …………………………….., in his/her capacity as legal representative or person granted the suitable powers, in the name and on behalf of the Company …………..[Applicant] ……….., with registered office in ……………………………, Share Capital € ……………………, Tax Code/Vat Reg. no …………, registered with the companies' register of …………… at no. ……………, hereby sends forwards its application to sign up for Available and/or Released Slot, in accordance with the provisions of the Access Code, as follows:

Regasification capacity requested:

Year and month concerned
[yyyy/mm] / Number and Date of the Delivery Slot [##] / Delivery Slot
[m3liq]
[•] / [•] / [•]

and also declares:

  1. that [Applicant] holds LNG import contracts or agreements that provide for mutual undertakings between the parties aimed at making the quantity of LNG, for the import of which the capacity is requested, available;
  2. for each of said import contracts, the annual contracted quantities, the contract duration, the name of the authorized LNG Carrier(s), the country producing the LNG and the loading port are those shown in the table below;
  3. all the information shown in this declaration is provided for the purpose of the regasification capacity booking during the Gas Year by OLT Offshore LNG Toscana S.p.A., in accordance with the provisions set forth in the Access Code;
  4. the Applicant is a user of transportation service since it has already signed a transportation contract with SnamRete Gas S.p.A. valid for the entire duration of Service Period set out in the Capacity Contract that it will sign with OLT Offshore LNG Toscana S.p.A.or, in the event the Applicant does not satisfy this requirement, it will specify, in accordance with time and manners set out in the Access Code, one or more users of transportation service to whom allocate the entire gas quantities in order to redeliver them to SnamRete GasS.p.A..
  5. that is fully aware of and accepts all the terms and conditions shown in the Access Code;
  6. that it is fully aware of the criminal sanctions set forth in article 76 of the Decree of President of the Republic no. 445 dated 28/12/00 regarding false declarations and the forfeiture of any benefits obtained on the basis of untruthful declarations.

Contractual q.ty
[m3liq/period] / Contract duration
From [mm-yyyy] to [mm-yyyy] / Name
LNG Carrier(s) / Country of
LNG production / LNGLoadingPort
[•] / [•] / [•] / [•] / [•]

Respectfully,

[Place], [DD/MM/YYYY][SIGNATURE]

Attachment: photocopy of identity card of the person signing