For your convenience, you may designate a relative, friend, or agency to receive a reminder from us when your service becomes in danger of disconnection. Third-party designees are NOT responsible for paying your bill but can work with us on your behalf to avoid service interruptions. By completing and submitting this form you are requesting that a copy of any shut-off notice be given to the person or agency named below. National Fuel will not be liable if it fails to notify the Third Party.