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Non-Residential Gas Service Agreement for Natural Gas Customers 
Customer Information
* required information
Company Name: *
Contact First Name: *
Contact Last Name: *
E-mail Address: *
Confirm E-mail Address: *
Account Number: *  Where is this?
Phone Number: *  555.123.4567
Rate Zone: *

What is my rate zone?
Rider Type: *

What is my rider type?
Rate: *

What is my rate?
Requested Effective Date: *
Requested MDCQ: *  (Therms) What is MDCQ?
Tax Information
* required information
Are you exempt from the Gas Use Tax? *

What is the Gas Use Tax?
NOTE: If you purchase gas from an Illinois broker or marketer and pay tax on the purchase, you must provide a completed Form RG-12 to your delivering supplier to prevent your delivering supplier from charging you Gas Use Tax.
Are you exempt from the Gas Revenue Tax? *

What is the Gas Revenue Tax?

Account Number

Your ten digit account number located on your Ameren bill.

Rate Zone

Rate Zone is the service territory in which your account resides. Zone I - formerly AmerenCIPS, Zone II - formerly AmerenCILCO and Zone III - formerly AmerenIP.

Your Rate Zone can be found on your Ameren bill under the Natural Gas Service Billing Detail.

Rider Type

Rider T - Available to any non-residential customer within Ameren Illinois' service area served under Rates GDS-2, GDS-3, GDS-4, GDS-5 or GDS-7 of this Schedule having contracted with Ameren Illinois for transportation service of Customer-Owned Gas.
Rider S - All residential customers receiving gas delivery service pursuant to Rate GDS-1 - Residential Gas Delivery Service shall receive system gas supply from Ameren Illinois pursuant to this Rider S. Service under Rider is also available to all non-residential customers.

Your Rider type can be found on your Ameren bill under the Natural Gas Service Billing Detail.


All customers with gas service from Ameren Illinois will be served under a Gas Delivery Service (GDS) Rate classification. Non-residential customers shall receive service under Rate GDS-2, GDS-3, GDS-4, GDS-5 or GDS-7. Ameren Illinois shall use the criteria specified in the availability section of each GDS Rate to determine if a customer is eligible for service under said Rate.


Your Gas Delivery Service Rate is located on your billing statement under Natural Gas Service Billing Detail.


MDCQ is the maximum number of therms of gas Ameren Illinois shall be obligated to deliver to the customer on any day. Usage on any day in excess of the MDCQ shall be subject to overrun charges, if applicable.

Gas Use Tax

Pursuant to Section 5-15 of Public Act 93-0031 (Gas Use Tax Law), a tax is imposed upon the privilege of using gas obtained in a purchase of out-of-state gas. For purchasers who have not provided Ameren Illinois with a Gas Use Tax Exemption Certificate or a Gas Use Tax Self-Assessor Certification, Ameren Illinois is obligated to collect this tax at the rate of 2.4 cents per therm.


Ameren Illinois will continue to collect Gas Revenue Tax on transactions for services it provides to Customers whose gas usage is exempt from Gas Use Tax.

Gas Revenue Tax

Pursuant to Section 2 of "The Gas Revenue Tax Act," a tax is imposed upon persons engaged in the business of distributing, supplying, furnishing, or selling gas to persons for use or consumption and not for resale at the rate of 2.4 cents per therm of all gas which is so distributed, supplied, furnished, sold, or transported to or for each customer in the course of such business, or 5% of the gross receipts received from each customer from such business, whichever is the lower rate as applied to each customer for that customer’s billing period. This tax shall not be imposed on transactions with customers who incur a tax liability under the “Gas Use Tax Law.”


Any person who submits false or inaccurate information as part of this form may be subject to fines and/or punishment pursuant to applicable federal and/or state laws and regulations.

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