Date of sighting: _____________ Date of occurrence: ____________ Date of capture: ___________
Time of sighting: _____________ Time of occurrence: __________ __ Time of capture: _______ __ MidstreamOn Bank Victim Status: Alive Dead RiverLake In vegetation In Mud Human Animal CreekStream Shallow water on edge ____ Age Pls. specify Coastal Mangrove ____Gender________ __ Estimated size of crocodile: Distance from the community: Name: ________ _ _ < 1km > 1km < 5ft. 5-10 ft. 11- 15ft. Activity: ____________________ __ >15ft.Eyes Only Name of captor/s: ___________________________ __ No. of sighting/s: ____________ 1. ______________________ _______________________________ Daily 2-3x/week 2. ______________________ Evidence/s: Cause: Weekly Monthly Remains/CarcassProvoked 3. ______________________ Unobserved Bite wound Unprovoked Reason: ____________________ Crocodile Behavior: Witness______________________ ___________________________ Head Only Head to Back Survivor account _____________ ________________________________ _________________________ Full Body Underwater Tracks Only _______________________________ Estimated size of crocodile: Capture Method:____________ Distance from the community: < 5ft. 5-10 ft. 11- 15ft. __________________________ < 1km> 1km >15ft. Eyes Only No. of individual: _____ Witness/es: Size of crocodile: _____ Distance from the community: 1. _________________________ < 1km > 1km Holding facility: 2. ________________________ Previous incident reported: _________________________ 3. _________________________ Yes No