THE SCIENTIFIC RACCOON JOURNAL

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

Claims Against Raccoons - Damage to Land, Ponds & Equipment and Theft of Fish, Fruits and Vegetables

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 Damage and/or Theft 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 Monetary Damage and/or Theft Number of Properties Involved: ................

Estimated Damage to Ornamental Lawn(s):....................

Estimated Damage to Fruit Tree(s):.................................

Estimated Theft of Fruit from Tree(s):.............................

Estimated Damage to Grape Vines:.................................

Estimated Theft of Grapes from Vines(s):.......................

Estimated Damage to Pond(s) & Pool(s):........................

Estimated Theft of Fish from Pond(s):.............................

Estimated Damage to Vegetable Garden(s):.....................

Estimated Theft of Vegetables from Garden(s):...............

Estimated Damage to Ornamental Garden(s):.....................

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

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


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

Description of Damage and/or Theft Ornamental Lawn(s):.............

Orchard Tree(s):..........................

Theft of Tree Fruit:................

Grape Vines:..........................

Theft of Grapes:.....................

Pond(s) and Pool(s):..............

Theft of Fish:.........................

Vegetable Garden(s):.............

Theft of Vegetables:..............

Ornamental Garden(s):..........

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

Furniture & Equipment:......