Fuel Saver
5000 Independent Test Results
These independent test results for gas mileage increases shall be followed in
accordance to the follow
terms:
1) The said vehicle shall be test driven on a test drive by the owner of the
vehicle on which the Fuel Saver 5000 shall be installed.
2) The driving course shall be a length of 100 miles or greater {round trip}:
Before Installation and also after Installation.
3) The driving course shall consist of at least 95% on the road driving (a
constant freeway speed of 55mph or greater to posted
speed limit)
A) Non-freeway systems referring to your alternative commute bearing current
posted speed limit.
4) The first test shall be done without the Fuel Saver 5000 installed.
5) The First test mileage shall be documented after completion by the owner of
the vehicle and a secondary passenger
(witness).
6) The second test shall be done over the same driving course with the Fuel
Saver 5000 installed and adjusted according to the
Fuel Saver 5000 installation instructions.
7) The second test results shall be documented after completion by the owner of
the vehicle and a secondary passenger
(witness)
8) Upon completion of both tests the test results shall be documented and the
form below shall be filled out in its entirety along
with both the owner's signature and the secondary passenger's signature (witness).
9) The completed document shall be notarized by a public notary to verify the
signatures of the owner and the passenger
(witness)
Make and year of vehicle: ______________________________
Engine Type________________________
Type of fuel delivery system (Carburetor, Throttle body or Fuel Injection)
__________________
Length of test course in miles: _____________________Miles
Gas mileage BEFORE the Fuel Saver 5000 was installed: ____________MPG
Gas Mileage AFTER the Fuel Saver 5000 was installed: ____________MPG
Name and address of Owner of Vehicle:
___________________________________________
Name _____________________________________________________
Address ____________________ City _______________ State _____________ Zip
_______
Name and address of Passenger
(Witness):_______________________________________________
Name ____________________________________________________
Address ____________________ City _______________ State ______________ Zip
________
I hereby declare the above information is true and the test was followed in
accordance to the test guidelines
as stated in the above test guidelines:
Signature of Vehicle's Owner: _________________________________________________
Signature of Passenger (witness):
_______________________________________________
Notarized By: _______________________________________ Date: ________________,
2005
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