Bee-Pollinated Blueberry Crop Loss Claim Form
Claimant Name
Farm Name
Contact Information
Date of Claim
Farm Location
Total Blueberry Acreage
Affected Acreage
Date Crop Loss Occurred
Description of Loss (due to bee pollination issues)
Estimated Loss (yield, % or amount)
Supporting Evidence (e.g. photos, reports)
Bee Pollination Details (bee species, hive count, provider etc.)
Additional Comments