THE SCIENTIFIC RACCOON JOURNAL

A New Dog - Bringing Raccoons in from the Cold in Urban Areas

Claims Against Raccoons - Damage to a Chicken Coop(s) and Theft of Chickens and Eggs

Your Name and Contact Information Last Name: First Name:

Street Number: Street Name: Suite/Unit Number:

City: Canadian Province: Postal Code:

Home Phone: Cell Phone: Email Address:

Address of Chicken Coop(s) Damage (If Different Than Above) Street Number: Street Name: Suite: City:

Province: Postal Code: Contact Phone Number (if different than above):

Nature of the Claim - Estimated Chicken Coop Monetary Damage and/or Theft Number of Coops Involved: ........

Estimated Monetary Amount of Damage to Roof(s):

Estimated Damage to Wall(s):....................................

Estimated Damage to Floor(s):...................................

Estimated Damage to Crawl Space(s):........................

Estimated Damage to Fixture(s):.................................

Estimated Damage to Furniture & Equipment:...........

Estimated Loss of Eggs:..............................................

Estimated Loss of Chickens:.......................................


TOTAL AMOUNT OF CLAIM:.................................

Description of the Damage and/or Theft to Chicken Coop(s), Eggs and Chickens Roof(s):...............................

Wall(s):...............................

Floors:.................................

Crawl Space(s):..................

Fixture(s):...........................

Furniture & Equipment:....

Theft of Eggs:....................

Chickens Lost:...................