Niue Census Form - 2001 Page 5

- 5 -

WARNING: Divulging of any information collected from the census and mutilation or defacement of the schedule is prohibited according to Sections (16) and (17) of the Niue Census Ordinance 1971.

Are you and your household aware of the harmful effects of chemicals to the environment and health?

(Mark the appropriate box with an X)

(102)

Yes

Are you prepared or willing to reduce the amount of chemicals used by your household?

(Mark the appropriate box with an X)

(103)

Yes

AT THE END OF THE INTERVIEW, PLEASE GO THROUGH THE FORM AND ENSURE THAT

ALL QUESTIONS ARE ANSWERED.

WARNING: Divulging of any information collected from the census and mutilation or defacement of the schedule is prohibited according to Sections (16) and (17) of the Niue Census Ordinance

1971.