Anterra Wines Order Form 
 If paying by credit card, print and fax completed order form to: 707.257.2930
If paying by check or money order, send completed order form and check to:
Anterra Wines
P.O. Box  931
Yountville, CA 94599

 Name: __________________________________________________________                                         
 
Address: ________________________________________________________

City: __________________________________   State: ____   Zip:  _________

Phone: _______________ e-Mail (optional): ___________________________

                                                                                                        Quantity

        2002 Anterra Merlot ($24.99 / bottle or $270.00 / case):                            ___ (Bottles) ___ (Cases)

        2002 Anterra Cabernet Sauvignon ($29.99 / bottle or $324.00 / case):       ___ (Bottles) ___ (Cases)

        Sub-Total:                                                                                                        $_______

        7.75% Sales Tax (CA residents only - multiply by 0.0775):                         $_______

        Shipping Cost (please contact winery for shipping cost):                            $_______

        Total Payment:                                                                                                $_______

Send check, money order or pay by Credit Card
Credit Card (check one):   [  ] Visa     [  ] Mastercard
Card Number: ____________________________________   Expiration Date: ___/___
Name on Card: ___________________________________

Notes:
(1) Buyer must be at least 21 years of age. An adult signature is required upon delivery for wine shipments.
(2) Please include 7.75% sales tax for shipments of wine within California.
(3) If you are outside of California then please contact the winery in advance of placing an order to verify
      if the wine can be shipped directly to your state.

Thank You for Your Order!
Anterra Wines
Phone/Fax:  707.257.2930
Email: anterrawine@aol.com