Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Name & Surname: *FirstLastCompany Name:Email: * Farm Fire: Name: Contact Number: *Location of Fire: Local Municipality:SelectPhumelelaMaluti-a-PhofungLocation of Fire: Farm Name & Number *FirstLastMultiple Fires? *YesNoIgnition: Month: *SelectJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberIgnition: Day: Day: 1 Extinguished: Month: *SelectJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberExtinguished: Day: Day: 1 Cause of Fire *Prescribed Burn (Firebreaks, Refuse dump, Fuel Reduction)HumanMechanical (Motor Vehicle, Train, Power Tools, Blasting, Powerlines)Natural (Ligtning. Static Electricity, Falling rocks)OtherSpecify below:Specify Cause:Hectares Lost: *Give Hectares Lost in this Incident:Summary of vegetation that were lost:Submit