Report on pandanus dieback

Report on pandanus dieback
To report pandanus trees that you suspect to be infected by planthopper, please fill in as many details as possible below, then click 'submit'.
Title-----MrMrsMsMissDr  Surname:
First Name:
Company / Organisation:
Postal address:
Town or suburb:
State:	Postcode:
Country:
Email address:
Telephone number(s):	Business hours:   Mobile:
The lot and DP of the property where the pandanus is growing (if known):
Please describe the location of the pandanus trees:
If possible, please provide a GPS or map reference:	Latitude:    °   '   " S Longitude:  °   '   " E If your coordinates are in digital format (eg. 33.86667°S), you can convert to degrees, minutes and seconds online.
Symptoms of dieback seen on the trees (you may choose more than one option):	Yellow leaves Mould Dead plant
Number of trees affected
Do you want your personal details to be kept confidential to the DECC?	YesNo
	Any comments you make on this form, including your personal details, will be a matter of public record and will be stored in the DECC records system. The submission of personal information with your comments is voluntary. You can find out more about how DECC handles the personal information it collects online by reading our privacy policy. By submitting this form, you consent to the collection and use of your personal information in accordance with this policy.