Delivery Request Form

Fill out this form to request a package from your vendor or shop.

Your Details

Your Name

This will be used to identify your package.

Your Phone Number

This will be used to communicate with you about the status of your package.

Package Details

Package Name / Label

This is the name of the item you have purchased.

Package Cost / Amount

This is the cost of the item that you have purchased.

Package Category

Delivery Details

Your Area

Specific Area

Your Region

Your Area

Seller Details

Seller Name (or Business Name)

This will be used identify the seller business.

Seller Contact Phone Number

This will be used to communicate with the seller about the package.

Seller's Region

Seller Location / Area

Delivery Cost Breakdown

Delivery Fee
(VAT) 16%
Total	0

Delivery Fee Payment

Enter your M-Pesa Number to Pay.

Confirm Your Details

Delivery Method
Delivery Fee

Your Details
Your Name
Your Phone Number
Package Details
Package Name
Package Cost
Package Category
Your Delivery Details
Your Agent Area
Your Pickup Point Agent
Your Doorstep Area
Your Doorstep Destination
Your Address
Your Xpress Destination
Your Exact Address
Seller Details
Seller Name
Seller Contact Number
Seller Location
Seller Agent
Seller Xpress Location
Seller Exact Address

Click here to indicate that: 1. You have confirmed that the information above is accurate and agree that PickupMtaani is not responsbile for any issues arising from incorrect information. 2. You agree to and will comply with Pickup Mtaani's terms and conditions.

Delivery Request Form

What do they mean?

Your Details

Account Details

Package Details

Delivery Details

Location Information

Seller Details

Delivery Cost Breakdown

Delivery Fee Payment

Payment Confirmation

Confirm Your Details

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