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Courier & 3rd Party collection form:

Godlela Pty Ltd


I the undersigned Mr/Miss/Mrs / Business Name ____________________________

8507140984085
I.D / PASSPORT NO: _________________________ hereby give consent to

Keanetse Maloke
Mr/Miss/Mrs/ Courier Company: _________________________

9007120354085
ID / Passport No/Courier Name : ____________________________ to collect my goods from Home in 1

on my behalf.

1677052
Home in 1 invoice no: ________________________.
By signing this document I acknowledge that I will have no claim against Home in 1 for any damages,
shortages or liability.

CUSTOMER PERSON RESPONSIBLE FOR COLLECTION

Refiloe Dhladhla
NAME: ___________________ Keanetse Maloke
NAME: ____________________

SIGNED: ___________________ SIGNED: ____________________

DATE: 2023/2/24
___________________ 9007120354085
I.D. No: _____________________

TSX645GP
VEHICLE REG: ________________

DATE: 2023/2/24
____________________
Authorisation given by Email / Whatsapp will be printed and attached to this document.

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