Kosher Wine Request Form
Instructions:
1. Complete this form using the list of kosher wines available on the
Comptroller of Maryland’s website.
2. Take the form to your local retailer.
3. If the retailer does not already carry the wine you are requesting, the
retailer will contact the distributor identified on the form.
4. The distributor, in most cases, will be able to deliver the requested wine
to the retailer as part of the next delivery.
5. Pick up the wine on the date indicated by the retailer.
Brand Name of Wine: _______________________________________
Varietal (or Type): __________________________________________
Distributor of Wine: _________________________________________