Limpopo North West Gauteng Mpumalanga Kwa Zulu Natal Free State Eastern Cape Western Cape Northern Cape Namibia'

Collection Request Form
Note: Please complete and submit the form below to arrange for a collection. Please note that one of our National Contact Centre staff will contact you to confirm the booking and to provide you with a reference number for tracking purposes. Should you require liability, please clearly select this option when completing the form.
* Required fields. Please complete the information below:

Account Holder Information:

Your name:
Your telephone number:
Your fax number:
Your email address:
Account or PAK number:
Is this a third party collection?:
Yes No

Collection Details:

Contact name:
Company name:
Contact telephone number:
Collection department (e.g. reception, security, warehouse):
Collection Address:
Postal Code:
Required collection date:
What time will the parcel be ready?:
Company closing time:
Can the parcel be collected from Security?:
Yes No
According to the shipment size, what vehicle type will be required?:

Shipment details:

Number of shipments:
Combined number of parcels:
Combined weight:

Details of Shipment 1:

Receiver's contact name:
Receiver's contact number:
Delivery address:
Postal code1:
Number of parcels:
Service type:
Do you need liability?:
Yes No
If liablity is required please state value of shipment in rands:
Shipment contents:

Details of Shipment 2:

Receivers contact name:
Receivers contact number:
Delivery address2:
Postal code2:
Number of parcels2:
Service Type2:
Do you need liability2?:
Yes No
If liability is required please state value of shipment in rands2:
Shipment contents2:
Available times for Security:
Special handling instructions:
Do you need stationery?:
Yes No