Ghost Riders Wines Print & Fax Order Form
TAX INVOICE

licence no. 24009914
ABN: 34 310 331 875

Vintage	Premium Wine	Bottle price	Case Price	Qty	Total
2002	Shiraz – First vintage	$20.00	$220.00 (SOLD OUT)
2003	Shiraz	$18.00	$198.00
2004	Shiraz	$18.00	$198.00
2005	Shiraz	$22.00	$242.00
2006	Chardonnay	$18.00	$198.00 (SOLD OUT)
2007	Chardonnay	$18.00	$198.00
2006	Shiraz Viognier	$20.00	$220.00
2007	Reserve Shiraz	$24.00	$264.00
Freight charges: NSW $5.00 or Interstate $10.00. Overseas on request
TOTAL

Name		Date of Birth	/ /
Delivery Address		Email
Town/City		Post Code
Phone		Fax
Name on Card		Card Number Expiry
	Cheque Money Order	Visa Mastercard
Delivery Instructions
Signature	__________________________________________________

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LIQUOR ACT 1982 IT IS AN OFFENCE TO SELL OR SUPPLY TO OR OBTAIN LIQUOR ON BEHALF OF A PERSON UNDER THE AGE OF 18 YEARS

Ghost Riders Vineyard
535 Hermitage Road, Pokolbin NSW Australia 2320
phone/fax 02 9653 3823 , mobile 0412 522 779
email. wine@ghostriderswines.com.au