agriculture damage report format

DAMAGE ASSESSMENT REPORT FOR CEREALS
					Cause of Damage:                            El Niño
					Date of Occurrence :               November 2015
					Report as of :                             June 20, 2016
					Period Covered (Specify)
A. Geographic Information:												B. Type and Level of Report : (Pls. Check)
	1. Region:	NIR										1. Type					2. Level
	2. Province:	NEG. OCC.												- Initial					- Municipal
	3. Municipality:													- Progress					- Provincial
														- Final					- Regional
C. Particulars:
							AREA AFFECTED (HA.)			YIELD PER				TOTAL  LOSSES
	BARANGAY/	TYPE OF CROP/	NUMBER OF	AREA OF	STAGE OF CROP	MONTH TO BE				HECTARE (M.T.)			VOLUME
LINE	MUNICIPALITY/	ECOSYSTEM	FARMERS	STANDING	DEVELOPMENT	HARVESTED	TOTAL					Yield	(MT)	Based on Cost of Input		Based on Farm Gate Price
NO.	PROVINCE		AFFECTED	CROP (HA)				Totally	Partially	Before	After	Loss		Cost of	Total			Total Value
								Damaged	Damaged	Calamity	Calamity	(%)		Input/	Value	Volume	Price/kg
														Ha. (P)		(MT)
(1)	(2)	(3)	(4)	(5)	(6)	(7)	(8)	(9)	(10)	(11)	(12)	(13)	(14)	(15)	(16)	(17)	(18)	(19)
																		Crop Damage	Production Losses
																		(Seedling to Vegetative Stage)	(Reproductive to Maturity)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
98
D.	Collector's Information
										TOTAL VALUE OF CROP DAMAGE				(COL. 19) =
										AND PRODUCTION LOSSES
Prepared by:													Reviewed by:
	Date :												Date :