

| Shipping Instructions: | Credit Card Information: |
|---|---|
| Name | Name as it appears on card |
| ____________________________ | ____________________________ |
| Telephone | Card number |
| ____________________________ | ____________________________ |
| UPS Address | Expiration Date |
| ____________________________ | ____________________________ |
| City | Card Type - Visa or MC | ____________________________ | ____________________________ | State / Zip | Signature | ____________________________ | ____________________________ |
Email for Wine Information
(209) 728-1658
FAX (209) 728-1658