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紅酒出產的國家 *
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紅酒的品牌名稱及年份 ( XXX 2016) *
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歐洲商品條碼或其他 (EAN13/8,UPC,...., or tbd) *
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代理商或銷售商 *
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聯絡人姓名 *
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聯絡人電話 *
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電子信箱 *
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您的匯款帳號 (對帳用) *
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匯款金額 *
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紅酒寄出日期 *
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