Instructions & Information

  1. Complete and sign all sections applicable to your organization.
  2. Please do not leave fields empty. If not applicable, write “N/A”
  3. If your organization is sales tax exempt, attach a copy of your exempt certificate and fill Certificate of Resale / Tax Exempt.
  4. Our terms are NET 15 from date of service.
  5. Please complete form below or download a Microsoft Word version and fax completed/signed application to ACCOUNTING Department at (813) 886-8229.
  6. Word version can be printed or filled using Microsoft Word (use TAB key to move to next field, SHIFT + TAB to move to previous field).

8326 E Adamo Dr. | TampaFL 33619

Phone: 813-886-8862 | Fax: 813-886-8229


16810 Oriole Road | Fort MyersFL 33912

Phone: 239-425-1537 | Fax: 239-225-0423

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Manko Delivery Systems