Gas Saver Order Form
          Fuel Atomizer 3000
     Gasoline Saver Atomizer
   The fuel atomizer 3000 is America's favorite gasoline saver and used, world wide. The fuel atomizer 2000 has been the popular gasoline saver around the world. Be sure to check you fuel system for a return line, or view the Fuel Atomizer 3000, to purchase yours today, "please print out this form".
     Orders     (888) 436-0899
         eFax   (208) 692-3632
   I, the undersigned, do hereby apply for inclusion to the "Auto Club", and its to my understanding that as a part of this program that I receive a 90 day manufacturer's warranty on each kit purchased. I also understand that I will by receiving a "Fuel Atomizer 3000" as my part of the auto club participation, I am eligible to purchase additional Fuel Atomizer 3000s at a discount for more than two additional units.
   I UNDERSTAND THAT MY INCLUSIVE PART BEGINS WITH A "ONE TIME" ATOMIZER PURCHASE OF NOW $149.95, PLUS   $12.95   IN THE U.S.A. FOR GROUND UNINSURED OR, $9.00 INSURED SHIPPING. WARRANTY IS FOR ALL MATERIALS INVOLVED, WHICH INCLUDES A FUEL ATOMIZER 3000 THAT ONCE SOLD FOR $350.   LA Basin Area of California contact dealer     Purchase securely online here.
Please do not cut line
__ I want to be a part of the Auto Club.      Vehicle : _____________           Year: ____________           Engine Size : ______________________
                                                                                        Need a Universal or Ford Kit ___   (call for price)                 Fuel Injected __ Carburetor __ Throttle Body __

(Discount on PO Money Order’s Send only $150.00 each Unit Purchased)
US Postal Money Order # ______________        Amount $_______.___
Make Payable and Mail to: AGS FA 3000
                                                PO Box 1699
                                                Riverton, Wyoming 82501

Or, Charge my: Visa __M/C__ American Express __ Debit(visa-M/C) __ (add 5% on top of total)      
Expires:____,200__                 Acct#:_________/_________/_________/_________                 Total Amount $ ______.___

Name as Appears:__________________________            Signature (required):___________________________            PIN#: __________ (3 digits on back of card)
                                       Shipping Information: (please type or print clearly)
Name:________________________________
Address: ____________________________ City: ________________________
State/Province:____________________ Country:________________________
Postal Zip Code#:____________________ Phone#: (______)________________
Fax:_____________________________              Today:                                       
Your current e'mail address:_________________________________________
                                                    Use iExplorer to print out completely
   Warranty void without (signed) application. This inclusive part carries a lifetime parts replacement for your atomizer. Should you desire a distributorship in time, your distributive number will be assigned to you: #________,  meanwhile your order form will receive immediate attention.
Warranty*
   Should "inoperable" problems arise with technical support assistance? If we should find that the Fuel Atomizer 3000 has been tampered with or changed in any way, your warranty work will be void.