Fuel Saver Carburetor Vaporizer Fuel Saver
      Gas Saver Order Form
      Fuel Vaporizer HB mpg
     Gasoline Saver Atomizer
   The fuel vaporizer adapter is America's favorite gasoline saver and used, world wide. The fuel vaporizer has been the popular gasoline saver around the world. Be sure to check you fuel system for a return line, or view the Fuel Vaporizer HB, to purchase yours today, "please print out this form".
     Orders     (888) 436-0899
         eFax   (206) 426-7446
   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 Vaporizer" as my part of the auto club participation, I am eligible to purchase additional Fuel Vaporizers at a discount for more than two additional units.
   I UNDERSTAND THAT MY INCLUSIVE PART BEGINS WITH A "ONE TIME" ATOMIZER PURCHASE OF NOW $199.99, PLUS   $12.95   IN THE U.S.A. FOR GROUND UNINSURED OR, $10.00 INSURED SHIPPING. WARRANTY IS FOR ALL MATERIALS INVOLVED, WHICH INCLUDES A FUEL VAPORIZER THAT ONCE SOLD FOR $350.
Please do not cut line
__ I certify that I do not own a vaporizer HB and want with my purchase of a vapor adapter kit (if the HB is not indicated, only your kit purchase will sent) by placing a check mark on the picture or circling it below
                         Click on a picture for more
         Vaporizer Kit fuel atomizer 2000 fuel saver, fuel system saver gas economy automotive add on Condensator Vaporizer HB

     Vehicle: _____________   Engine Size: _________Liter or CID           Year: ____________
                                                               My Purchase is for a Regular Adapter ___   My Purchase is for the Ford "only" Adapter ____
                Fuel Injected __ Carburetor __ Throttle Body __

(U S Postal Money Orders in USA Only - Send $175.00 each Adapter add $10. to insure)
                                US Postal Money Order # ______________        Amount $_______.___
                                          Payable and Mail to:      AGS Adaptor Kit
                                                                                PO Box 6191
                                                                                Riverton, Wyoming 82501

Credit Card Buyers
Charge Card Price: $182.00 (add 10% to total for CC use) or $18.00 = $200.00 add $10. to insure
Using my: Visa __M/C__ American Express __ (Visa-M/C Debit) __      

Expires:____, 20____                 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 above as a lifetime warranty will rermain for as long as you keep your purchase receipt.
Warranty*    Should "inoperable" problems arise with technical support assistance? If we should find that the Fuel Vaporizer Adapter has been tampered with or changed in any way, your warranty work will be void.