MarshAnne Landing Winery

Fax Order Form

(Secure ordering: Print, Complete Form, Sign and Fax or Mail back to MarshAnne Landing)

To: MarshAnne Landing, 381 Hogan Road, Oakland, OR 97462 Fax Number (541) 459-4499

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Customer Information

Note - you must be 21 years of age or older to purchase wine. Wines will be shipped after receipt of payment. The delivery agent (UPS) requires an adult signature upon delivery. We ship wines anywhere the law allows.

Name: _____________________________________________________________________

Billing Address: ________________________________________ City/State/Zip: _________________

Billing Phone Number: ____________________________ Email Address: _________________

Shipping Address: ____________________________________ City/State/Zip: _________________

Shipping Phone Number: _________________________ Email Address: _________________

Check or Credit Card (VISA/MasterCard): Check enclosed: ____ (Please call for shipping charges)

Credit Card Type: __________ Number: _______ ________ ________ ________ Expiration: ______/_______

Authorized Signature: _____________________________________________

Date of Birth: _________/__________/____________

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Order Information (Note: Landing Party members, additional discounts apply)

Please enter the quantity of the Wines you are purchasing/ Mixed Cases Yes! (One Case=12 bottles)

Wines	Quantity	Bottle Price	1/2 Case Price*	Case Price*
'01 Merlot		$14.00	$75.00	$130.00**
'05 Merlot		$18.00	$98.00	$172.00
'07 Cabernet Franc		$20.00	$108.00	$192.00
'05 Syrah		$22.00	$119.00	$211.00
'08 Chardonnay		$18.00	$98.00	$172.00
'05 Red Planet		$20.00	$108.00	$192.00
'07 Caballo		$25.00	$135.00	$240.00
Totals:

* Includes a 20% discount -- 10% for all half cases

** Close out special 30% discount

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Shipping Information*

We ship UPS Ground to any legal US State.

Total Purchase Order: Total Wine: ___________ + Shipping (winery will calculate)

Out of state shipping, where allowed by law, is available to either business or home street address. An adult signature will be required.