Parking Permit Application

Application for Disabled Person or Expectant Mother Parking Permit
Processing Associate
Denial Reason
All fields marked with * are required and must be filled.

Important Information About Your Online Transaction

Permanent Parking Permit Requirements

The following must be submitted with your application:
- A legible image of the completed Disabled Parking Permit Application (HSMV 83039) or the Certificate of Disability
- A legible image of your valid, unexpired Florida driver license
Temporary Parking Permit Requirements

The following must be submitted with your application:
- A legible image of the completed Disabled Parking Permit Application (HSMV 83039) or completed Application for Expectant Mother Parking Permit (HSMV 83040)
- A legible image of your valid, unexpired identification (examples: driver license, ID card, or passport)
  - Exception: If you are not a US citizen, you must submit a legible image of your passport and your out of country parking permit
- Payment of $15.00 + $0.76 processing fee*
*When completing the transaction online, there is an additional processing fee. The Tax Collector's office does not receive any portion of this fee.

There are no refunds. Once your transaction is processed we are unable to refund, reverse, or cancel your transaction.

No Additional Fee Option

To avoid the processing fee, see our customer publication for more options.

Sensitive Information Acknowledgement

By submitting this form, you acknowledge and accept that you are providing sensitive information to the Manatee County Tax Collector in order to enable us to complete your transaction.

I have read and understand the information shown and attest that I am a Manatee County resident.*

YesNo
You are NOT eligible to complete this application online.

Our office only serves Manatee County residents. You must visit a Manatee County Tag Agency or your home county to complete your transaction. Refer to the customer information publication for information.

What type of permit are you applying for?*

PermanentTemporary
Example:
Example:
Please note: A Temporary Disabled Parking Permit is $15.00 with a $0.76 processing fee. If do not wish to pay the additional fee, you must mail a check along with your completed application to: Manatee County Tax Collector, P.O. Box 25300, Bradenton, FL 34206 OR schedule an appointment online at taxcollector.com to have your transaction processed at one of our offices.

Do you (the disabled person) currently have a FLORIDA Driver License or FLORIDA Identification Card?*

YesNo
Do you (the disabled person) currently have a US driver license, US ID card, or passport?*

YesNo
Driver License Number or ID Card Number*
You are NOT eligible for a permanent parking permit.

You MUST have the Disabled Parking Permit Application (HSMV 83039) AND have a current Florida Driver License or Identification Card to be eligible for a permanent parking permit.
You are NOT eligible for a temporary parking permit.

You MUST have the Disabled Parking Permit Application (HSMV 83039) AND have a current driver license, identification card, or passport to be eligible for a temporary parking permit.

Do you have a current permit that is lost, destroyed or stolen, OR you never received your permit by mail, and you are submitting this form to request a replacement?*

YesNo

Submit Your Document

You must submit the front side of the completed HSMV 83039 or the Certificate of Disability from your renewal notice, as well as a copy of your identification document(driver license, ID card, or passport). The files/images uploaded must be legible or the application is subject to rejection.
Scan or take a photo of your completed Disabled Parking Permit Application (HSMV 83039) and identification document to upload here.*

Cancelof

Personal Information (Disabled Person)
Full name of disabled person, as it appears on the driver license or identification card*

First NameMiddle NameLast Name
Email*
example@example.com
Mailing Address (If DIFFERENT)

If you would like your parking permit mailed to a DIFFERENT address than what is listed on the Disabled Parking Permit Application or renewal notice, please enter that below. (Your address on file will not change, and it will not apply to any future transactions.)
Mailing Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry

Payment Details
No payment is required for a permanent parking permit, please hit Next below.
Billing Email*
example@example.com
Billing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

By submitting your disabled parking permit application online, you will receive updates regarding the status of your Parking Permit application via email. Allow 3 business days for the application to be processed.
By Checking the Box Below, I Consent to Providing an Electronic Signature*

Consent Given
Date*

MonthDayYear
Signature

Clear
Please Type Your Name Here to Submit Your Signature*
Parking Permit Fee*
prevnext( X )
Temporary Parking Permit ($15.00 + $0.76 Processing Fee)
$15.76

Total

$0.00
Should be Empty:

Application for Disabled Person or Expectant Mother Parking Permit

Submit Your Document

Personal Information (Disabled Person)

Mailing Address (If DIFFERENT)

Payment Details