Name: (as printed on card)

*

Account #:

Expiration Date: 00/00

*

*

Address:

*

City:

State:

*

*

Zip Code:

*

Name:

*

Address:

*

City:

State:

*

*

Zip Code:

*

Phone:

Type of Phone:

- - *

Home Business Cellular *

Email Address:

*

Please add comments or requests.

*

By checking this box, I agree to the following: We make no representation to the legal rights of anyone to ship or import wines into any state outside California. All alcoholic beverages are sold in California and title passes to the buyer in this state. The buyer is solely responsible for the shipment of alcoholic beverages. By placing an order, you authrize us to act on your behalf to engage a common carrier to deliver your order to you. Alcoholic beverages may be sold and delivered only to persons who are at least 21 years old. By placing your order with the Ramian Estate, you represent to us that you are at least 21 years of age and the person to whom the delivery will be made is at least 21 years old. When your alcoholic beverages are delivered the person receiving the delivery will be required to show identification proving that he or she is at least 21 years old.