Your name:
Address:
Telephone:
E-mail:
Name(s) of Observers:
Today's Date:	2012-02-07 19:12:17

Do you want us to protect (i.e. , prevent disclosure to the general public) the identification and location information you provide below? Yes No

If so, reason for sensitivity:

IDENTIFICATION

Please select the species type that you are reporting.

Plant Animal (vertebrate) Animal (invertebrate) Natural Community


Basis for identification:
     Personal knowledge
     Reference key
     Field guide
     Museum specimen
     Expert
     Other

Name of reference/guide/museum/expert:

Other:

Did you take a photograph? (If possible, please use the email link at the bottom of the page to attach a copy of the photograph.)
Yes No

Did you collect a specimen?
Yes No

      If so, was a speciman deposited at a museum or herbarium?
      Yes No

      If so:
      Collection Number: Repository:

Do you think that your identification requires confirmation? Yes No


LOCATION

County:

--- Choose County --- ALACHUA BAKER BAY BRADFORD BREVARD BROWARD CALHOUN CHARLOTTE CITRUS CLAY COLLIER COLUMBIA DADE DE SOTO DIXIE DUVAL ESCAMBIA FLAGLER FRANKLIN GADSDEN GILCHRIST GLADES GULF HAMILTON HARDEE HENDRY HERNANDO HOLMES HIGHLANDS HILLSBOROUGH HOLMES INDIAN RIVER JACKSON JEFFERSON JACKSON JEFFERSON LAFAYETTE LAKE LEE LEON LEVY LIBERTY MADISON MANATEE MARION MARTIN MONROE NASSAU OKALOOSA OKEECHOBEE ORANGE OSCEOLA PALM BEACH PASCO PINELLAS POLK PUTNAM SANTA ROSA SARASOTA SEMINOLE ST. JOHNS ST. LUCIE SUMTER SUWANNEE TAYLOR UNION VOLUSIA WAKULLA WALTON WASHINGTON

Site or managed area name, if known:

Directions: Precise directions to the occurrence that use a readily locatable and relatively permanent landmark on or near the site (such as a road intersection, bridge, or natural landform) as the starting point. Include distances and directions from landmarks, as appropriate. Please note -- neither the directions nor the coordinate information will be provided to the general public if the data are to be considered sensitive, as indicated above.
Latitude: N    Longitude: W

Datum: NAD27 WGS84/NAD83 Unknown

Source of latitude/longitude coordinates?

GPS
	Make:
	Model:
	Accuracy:	meters
	DGPS?	Yes No Unknown
	WAAS?	Yes No Unknown
Other
	Describe:

If possible, email an electronic image of the location. It is preferable to mark the site on a copy of an aerial photograph or a USGS 7.5" topographic map. Otherwise, please provide a sketch of the vicinity showing the occurrence in relation to towns, roads, landforms, water bodies, and other natural features, including ecological communities. Please include also an indication of scale and a north arrow.


If you have maps or photographs to include with this form, please email them to FNAI with the Subject Line:

OBSERVATIONAL INFORMATION

Date of Observation (yyyy/mm/dd): Time of Day:

Estimate of Total Area Observed or Surveyed: m² or acres.

Percent of this area actually occupied by the population or community: %.
Approximate dimensions of the area occupied:
length m     width m

How did you collect the data? (e.g. visually observed from road, trap or capture methods, walking a path through community, formal survey, etc.)

Is there other suitable habitat (unsurveyed) in the vicinity? Yes No Don't Know

      Extent? (e.g. acres, miles)

Have you been to this location before? Yes No
      If so, when?

      Did you previously observe this species or community? Yes No Did Not Look For It

      If you have previously seen the population or community, do you think there is now:
      more?
      less?
      about the same amount as before?
      no way to compare

Please provide a general description or "word picture" of the area where this occurrence is located (i.e., the physical setting and ecological context), including habitat, dominant plant species, topography, hydrology, soils, adjacent communities, and surrounding land use.

For Animals
Number of individuals (or nests, burrows, etc.) seen:

Age structure:

Estimated total number of individuals in population:
Basis?

Ecological & behavioral notes (e.g. reproductive stage, activity type [feeding, flying, nesting, etc.]):

For Plants
Number of individuals (or clumps, etc.) seen within the observed area:
Flowering?
Fruiting?
In bud?
In leaf?
Dormant?

For Communities
For each of three strata (tree, shrub, and ground layers), please list the dominant species comprising the stratum, together with an estimate of the height and percent cover for each stratum.

Stratum	Height (meters)	% cover	Species
Tree
Shrub
Ground

Describe species dominance relationships, vegetation heterogeneity, succession stage/dynamics, and any other unique aspects of the community or additional noteworthy species (including animals).

MANAGEMENT

Owner of the Site (if known):

Is the owner or manager protecting or managing the property for this species or community?
Yes No Don't Know

Are there disturbances or threats (e.g., urban development, agriculture, vehicle use, forestry, logging, fire suppression, ditching/draining, impoundment, exotic species, and natural disturbance) in the vicinity of the site?
Yes No Don't Know
If so, please describe type and severity:
Is there evidence (e.g., fire breaks, scorching) of the use of fire at the site?
Yes No Don't Know
Describe and give dates of recent fires, if known:
Comments on management history or needs:

OTHER

Additional comments concerning the population or community, its ecological conditions, contact information for other knowledgeable people, etc.:

Please print this form for your records before submitting.



If you have maps or photographs to include with this form,
please email them to FNAI
with the Subject Line: