Form

Order Form:

Name
Surname
Company
Vat n.
Address
Country
Town
Post code
Nation
Telefone
Mobile
Fax
E-Mail

Item	Price (Euro)	Quantity	Total
Cartons oil 6 bottles	44
Cartons oil 12 bottles	87
Tins oil 3 litres	33
Tins oil 5 litres	55
Cartons wine 6 bottles	23
Cartons wine 12 bottles	45
Cartons wine 12 bottles	45	TOTAL

Questions

Sending this form, I authorize Podere Vecciano to the personal details treatment according law 31/12/1996 n° 675.

We will answer as soon as possible. Thank You.