                                  CEQ-EPA Presidential Innovation Award for Environmental Educators Application

  Program History  Program History  The Presidential Innovation Award for Environmental Educators (PIAEE) recognizes outstanding kindergarten through grade 12 teachers who employ innovative approaches to environmental education and use the environment as a context for learning for their students. Up to two teachers from each of EPA's 10 regions, from different states, will be selected for this award. Since the passage of the 1990 National Environmental Education Act, the White House  Council on Environmental Quality (CEQ), in partnership with the U.S. Environmental Protection Agency (EPA), administers this award to nationally honor, support and encourage educators who incorporate environmental education in their classrooms and teaching methods.

  Eligibility  Eligibility  Teach K-12 on a full-time basis in a public school that is operated by a local education agency1, including schools funded by the Bureau of Indian Affairs;  Hold a current teaching license from the state (or valid reciprocity from the state for a license from another state);  Have a minimum of 5 years of K-12 teaching experience, including at least 3 years of teaching environmental education;  Anticipate a classroom teaching assignment involving environmental education for the upcoming school year;  Be a citizen of the United States, its territories or possessions, or lawfully admitted to the United States for permanent residency2; and      Has not been a recipient of this award in the past 5 years.

  Application Requirements:  Application Requirements:  There are 5 sections to the application:

 Section 1: General Information about the teacher  Teachers will provide contact information, perform an eligibility review, and a provide summary of teaching experience.

   1 For this program, a local education agency is one as defined by section 198 of the Elementary and Secondary Education Act of 1965 (now codified at 20 U.S.C. 7801(26)).  2 The U.S. Citizenship and Immigration Services defines lawful permanent residency as any person not a citizen of the United States who is residing in the United States under legally recognized and lawfully recorded permanent residence as an immigrant, also known as "Permanent Resident Alien," "Resident Alien Permit Holder," and "Green Card Holder."

 2018-2019 PIAEE Application Form  OMB Control No. 2090-0031 Approval expires: 3/31/2019               1	U.S. Environmental Protection Agency EPA Form No. 6500-04

 Section 2: Essays  Applicants are required to respond to essay questions addressing the selection criteria: Innovation, Achievement, Service to the Community and Underserved Communities, Leadership, and Integration.

 Section 3: Sample Teaching Materials  Applicants must include sample teaching materials that demonstrate the teacher's work with students.

 Section 4: Letters of Support  Each application must include 3 signed letters of support from an administrator at the teacher's school, a fellow teacher, and a past or current student.

 Section 5: Final Checklist  Applicants must complete a final checklist, certifying that they have completed all required sections of the applications.

  Selection Criteria  Selection Criteria  Teachers must have an outstanding record of teaching. Each of the factors below is meant to illustrate the applicant's record of teaching. Applicants will be judged by the responses to the questions in each of these five factors, as well as their sample teaching materials and letters of support.

 Innovation (25 points)  How does the teacher make learning about the environment unique, fun and exciting for his or her students? For example, does the teacher use experiential or place-based learning in ways that go above and beyond the practices of other teachers? Please be sure to demonstrate or exemplify this in the sample teaching materials.  How does the teacher tailor his/her teaching methods to the needs of his/her student population?  How does the teacher use any of the following topics as a basis to teach about environmental sustainability: a healthy school environment; environmentally friendly agriculture practices; human contributions to ocean litter and how to prevent it; school gardens; recycling; or STEM education?

 Achievement (15 points)        A.  What positive changes has the teacher seen in student academic achievement and behavior or attitude because of participation in the teacher's environmental education program?

 Service to the Community and Underserved Populations (20 points)  Many schools are part of communities that include minority, indigenous, low-income and underserved populations. Communities and their schools may also be in places that are heavily impacted by environmental pollution. While your community and school may or may not be considered one that is impacted, please answer the following.

 How does the teacher extend environmental education beyond the classroom? Are the teacher's students participating beyond the classroom in environmental, conservation, or earth science extracurricular or community-based projects and activities?  How does the teacher inspire the surrounding community, including parents/guardians and members of the community to participate in environmental education activities?

 Leadership (15 points)        A.  How does the teacher serve as a model for students and teachers with his/her approaches to teaching about the environment?

 Integration (10 points)        A.  How does the teacher help to integrate environmental education into the broader school curriculum or coordinate environmental education with other teachers and academic subjects?

 Sample Teaching Materials (10 points) Letters of Support (5 points)

  Winners and Honorable Mentions  Winners and Honorable Mentions  Winners will receive a Presidential award plaque and up to $2,500 to be used to further their professional development in environmental education.  Award winners' local education agencies will also receive up to $2,500 to fund environmental activities and programs. These funds cannot be used for construction costs, general expenses, salaries, bonuses, or other administrative expenses.  A congratulatory letter from a senior official from EPA and/or the White House.  Honorable Mention recipients will receive certificates of recognition.

  Program Timeline  Program Timeline  Application Deadline: April 5, 2019  Notification of Application Status: April-May 2019  EPA and White House Press Release Announcing Winners: Summer 2019

  Submission Instructions  Submission Instructions  Applications are accepted electronically and by hard copy. We prefer to receive applications by email.  All applications must be received by 11:59 p.m. ET on April 5, 2019.  Please ensure that the required supporting materials are included with the application submissions  -  a checklist is found on the last page of this application.  All applicants will receive an email confirmation that their application was received.

Electronic Submissions  Email complete application package, including all supporting materials, to<EMAIL_ADDRESS>Please include "Application for 2018-2019 PIAEE" in the subject line.

Hard Copy Submissions  Hard copies must be sent by a commercial delivery service and must be delivered by 5 p.m. ET on April 5, 2019 to be eligible for consideration. All applicants will receive a confirmation email upon receipt.

 Mail complete application package to:  Environmental Protection Agency Office of Environmental Education  Attn: Presidential Innovation Award for Environmental Educators  William Jefferson Clinton Building North, Room 1426-A 1200 Pennsylvania Ave., NW, MC 1704-A Washington, DC 20460

 The public reporting and recordkeeping burden for this collection of information is estimated to average 10 hours per response.  Send comments on the Agency's need for this information, the accuracy of the provided burden estimates, and any suggested methods for minimizing respondent burden, including using automated collection techniques to the Director, Collection Strategies Division, U.S. Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460.  Include the OMB control number in any correspondence.  Do not send the completed form to this address.

                             ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐  ☐  ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐  Teaching Experience:  How many years has the teacher taught K-12?  Teaching Experience:  How many years has the teacher taught K-12? Application Section 1: Contact

 Teacher Contact Information:	*required information  Prefix:  *First Name:  *Last Name:  MI:  Suffix:

 *Home Address:  *City:  *State:  *Zip:  *Primary Email Address:  *Home Phone:  Secondary Email Address:  Mobile Phone:

 School Information:  *School Name & Street Address:  *City:  *State:                                      *Zip:  *School Email address:

 *Phone #:  *School Website:  *School Tax ID#:

 Fax #:  *Principal Name:

 *Principal Phone:  *Principal Email:

 Grades:  K   1st

2nd

 3rd

4th   5th   6th   7th

8th

  9th

  10th   11th   12th

☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐ ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐

  Eligibility:  Check each box to confirm that the teacher meets the general eligibility requirements.  The teacher educates K-12 full time in a public school (including a Bureau of Indian Affairs school) that is operated by a local education agency3.  The teacher has a teaching license from the State (or valid reciprocity from the State for a license from another State).  The teacher has at least 5 years of teaching experience, and at least 3 years of teaching an environment-based curriculum and/or environmental education.  The teacher has a classroom teaching assignment involving environmental education for the coming year.  The teacher is a citizen of the United States, its territories or possessions, or lawfully admitted to the United States for permanent residency4.  The teacher has not been a recipient of this award in the past 5 years  Eligibility:  Check each box to confirm that the teacher meets the general eligibility requirements.  The teacher educates K-12 full time in a public school (including a Bureau of Indian Affairs school) that is operated by a local education agency3.  The teacher has a teaching license from the State (or valid reciprocity from the State for a license from another State).  The teacher has at least 5 years of teaching experience, and at least 3 years of teaching an environment-based curriculum and/or environmental education.  The teacher has a classroom teaching assignment involving environmental education for the coming year.  The teacher is a citizen of the United States, its territories or possessions, or lawfully admitted to the United States for permanent residency4.  The teacher has not been a recipient of this award in the past 5 years

 Where did you hear about this award program?

        EPA website

 EPA Headquarters Staff

        A friend or colleague

 EPA Regional Staff

        School Administration

 Press/Media

        Other (Please Specify):

           3 For this program, a local education agency is one as defined by section 98 of the Elementary and Secondary Education Act of 1965 (now codified at 20 U.S.C. 7801 (26)).      4 The U.S. Citizenship and Immigration Services defines lawful permanent residency as any person not a citizen of the United States who is residing in the United States under legally recognized and lawfully recorded permanent residence as an immigrant, also known as "Permanent Resident Alien," "Resident Alien Permit Holder," and "Green Card Holder."

                          Application Section 2: Essays

 Essays are listed under the following five headings: Innovation, Achievement, Service to the Community and Underserved Populations, Leadership, and Integration.  Teachers should be certain to clearly address every question in each heading area in a separate, attached document. Teachers must include sample teaching materials and may reference throughout their essays.  If the teacher's response to a question cites information provided in response to another question, or in the sample teaching materials, the response should clearly indicate where the information is located so that the reviewer may easily find it.  Essay length, font type and size specifications: The total length of essays must not exceed      9 pages. An essay may start on the same page as the previous essay ended. Additional pages will not be read or evaluated. Essays are to be written in Times New Roman font, size 12, line spacing 1.5, and margins no smaller than 1 inch.

  Essay 1: Innovation  Essay 1: Innovation

 How does the teacher make learning about the environment unique, fun and exciting for his or her students? For example, does the teacher using experiential or place-based learning in ways that go above and beyond the practices of other teachers? Please be sure to demonstrate or exemplify this in the sample teaching materials.  How does the teacher tailor his/her teaching methods to the needs of his/her student population?  How does the teacher use any of the following topics as a basis to teach about environmental sustainability: a healthy school environment; environmentally friendly agriculture practices; human contributions to ocean litter and how to prevent it; school gardens; recycling; or STEM education?

  Essay 2: Achievement  Essay 2: Achievement

        A.  What positive changes has the teacher seen in student academic achievement and behavior or attitude because of their participation in the environmental education program?

  Essay 3: Service to the Community and Underserved Populations  Essay 3: Service to the Community and Underserved Populations

  Many schools are part of communities that include minority, indigenous, low-income and underserved populations. Communities and their schools may also be in places that are heavily impacted by environmental pollution. While your community and school may or may not be considered one that is impacted, please answer the following.

 How does the teacher extend environmental education beyond the classroom? Are the teacher's students participating beyond the classroom in environmental, conservation, or earth science extracurricular or community based-projects and activities?  How does the teacher inspire the surrounding community, including parents/guardians and members of the community, to participate in environmental education activities?

  Essay 4: Leadership  Essay 4: Leadership

        A.  How does the teacher serve as a model for students and teachers with his/her approaches to teaching about the environment?

  Essay 5: Integration  Essay 5: Integration

        A.  How does the teacher help to integrate environmental education into the broader school curriculum or coordinate environmental education with other teachers and academic subjects?

                Application Section 3: Sample Teaching Materials

  Sample teaching materials must be submitted separately as attachments to this application.

  Content: Materials from one unit/curriculum or module that the teacher has taught. Indicate how these materials were used, and how the students responded to them.

 Source(s): The materials may be original to the teacher or may be from an existing education curricula source. If existing education curricula or activities are submitted, the source of the materials must be documented.

  Length: The total length of the sample teaching materials may not exceed 5 pages. A brief description of how the materials are used must be included. Teachers may include up to 5 pages of  photos, which must be clearly labeled. Photos are optional. Web links to supporting materials, such as photos (5 pages or fewer) and sound and/or video recordings (10 minutes or fewer or total playing time) may also be provided but must be accompanied by a brief description of the project. Reviewers will not attempt to find online content for invalid hyperlinks, so please make sure they are active.

  Sample Material Titles:  Sample Material Titles:  Please briefly list the titles of the materials that are included with this application in the space provided.

  Sample Material Use and Student Response:  Sample Material Use and Student Response:   Please briefly indicate how these materials were used and how the students responded to them, within the space provided.

                   Application Section 4: Letters of Support

 Each application must include a total of three signed letters of support. Letters must come from:  An administrator from the teacher's school  A fellow teacher  A past or current student

 Letters of support should not exceed one page and must include the following:  Relationship to the teacher;  Familiarity with the teacher and the work for which the teacher is being considered; and,  Perspective on why the teacher's work is unique and innovative in the field of environmental education, and how the teacher might inspire others to use environmental education.

 The letters must be submitted as attachments to the application. In the boxes below, identify the individuals who provided letters of support for this teacher.

  Letter 1: Administrator  Letter 1: Administrator

 Name  Title

 Organization/School  Email Address

  Letter 2: Fellow Teacher  Letter 2: Fellow Teacher

 Name  Title

 School  Email Address

  Letter 3: Past or Current Student  Letter 3: Past or Current Student

 Name  Address or Email

                        ☐  ☐  ☐  ☐  ☐  ☐  ☐  ☐ Application Section 5: Final Checklist

 Before submitting, be sure your application package includes:   ✔  Completed application, with essay responses.

 Copy of teacher's teaching license, state teacher certificate, or copy of online record (an active web link). Do not send original certificates.

 Sample teaching materials.

 Three letters of support.

 Signature

   	    ☐ ☐ Teacher Signature	Date


[Federal Register Volume 77, Number 182 (Wednesday, September 19, 2012)]
[Notices]
[Pages 58201-58202]
[FR Doc No: 2012-23038]

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SECURITIES AND EXCHANGE COMMISSION

[Release No. 34-67850; File No. SR-NSCC-2012-07]

 Self-Regulatory Organizations; National Securities Clearing
Corporation; Notice of Filing and Immediate Effectiveness of Proposed
Rule Change Which: (i) Eliminates the Practice of Netting of Creations
and Redemptions of Index Receipts Prior to Their Entering NSCC's
Accounting Operation, and (ii) Effects Certain Other Technical Changes

September 13, 2012.
    Pursuant to Section 19(b)(1) of the Securities Exchange Act of 1934
(``Act''),\1\ notice is hereby given that on September 4, 2012,
National Securities Clearing Corporation (``NSCC'') filed with the
Securities and Exchange Commission (``Commission'') the proposed rule
change as described in Items I and II below, which Items have been
prepared primarily by NSCC. NSCC filed the proposal pursuant to Section
19(b)(3)(A)(iii) of the Act,\2\ and Rule 19b-4(f)(4) \3\ thereunder so
that the proposal was effective upon filing with the Commission. The
Commission is publishing this notice to solicit comments on the
proposed rule change from interested persons.
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    \1\ 15 U.S.C. 78s(b)(1).
    \2\ 15 U.S.C. 78s(b)(3)(A)(iii).
    \3\ 17 CFR 240.19b-4(f)(4).
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I. Self-Regulatory Organization's Statement of the Terms of Substance
of the Proposed Rule Change

    The proposed rule change: (i) Eliminates the practice of netting of
creations and redemptions of index receipts prior to their entering
NSCC's Accounting Operation, and (ii) effects certain other technical
changes. Details are set forth in Exhibit 5 to NSCC's rule filing,
which can be found on NSCC's Web site (http://www.dtcc.com/downloads/legal/rule_filings/2012/nscc/SR-NSCC-2012-07.pdf).

II. Self-Regulatory Organization's Statement of the Purpose of, and
Statutory Basis for, the Proposed Rule Change

    In its filing with the Commission, NSCC included statements
concerning the purpose of and basis for the proposed rule change and
discussed any comments it received on the proposed rule change. The
text of these statements may be examined at the places specified in
Item IV below. NSCC has prepared summaries, set forth in sections (A),
(B) and (C) below, of the most significant aspects of such statements.

(A) Self-Regulatory Organization's Statement of the Purpose of, and
Statutory Basis for, the Proposed Rule Change

    NSCC reports on, clears and settles domestic index receipts (i.e.
shares in exchange-traded funds (``ETFs'')) and their underlying
component securities through a creation/redemption process, which is
initiated by a Member. As more fully described below, the purposes of
the proposed rule change are to: (a) Discontinue the current practice
of netting of ETF transactions prior to entering the Corporation's
Accounting Operation in order to: (1) Harmonize ETF processing with
that for other transaction types and (2) better facilitate Members'
internal reconciliation processes, and (b) make certain technical
corrections and clarifications to the Rules text with respect to
current ETF processing.
    NSCC's index receipt processing supports: (a) The establishment of
index receipt units (creation), whereby a Member will deliver the
underlying component securities or cash to the index receipt agent and
receive index receipts, and (b) the redemption of index receipt units
whereby a Member will deliver the index receipts and receive the
underlying components or cash. NSCC facilitates the processing of these
transactions as set forth below.\4\
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    \4\ For the NSCC rule filing which implemented ETF processing,
see Securities Exchange Act Release No. 31601 (December 16, 1992),
[File No. SR-NSCC-92-08].
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    NSCC's process for handling of index receipt transactions is set
forth in Procedure II, Section G. On the day before trade date (T-1),
an index receipt agent transmits files to NSCC which contain
information regarding the underlying composition of index receipts for
creates and redeems occurring the next business day. That evening, NSCC
compiles the information and provides the respective Members with a
portfolio composition report/file that lists the composition of index
receipts eligible for processing. The file displays the proportionate
amount of underlying components or cash \5\ that comprise each index
receipt. This file also contains a cash balancing component, which is
an estimation of accrued dividends, cash-in-lieu of securities and any
necessary balancing amount.\6\ The portfolio information contained in
this file is used for creation/redemption processing the next day, or
Trade Date (T). On T, by such time as established by NSCC, the index
receipt agent, on behalf of each Member placing an index receipt order,
will report to NSCC the number of index receipts created and redeemed
that day. Such transactions constitute locked-in transactions between
the index receipt agent and the relevant Members. The index receipt
agent also will report the final cash amount and a transaction amount
which represents the transaction fee. On the night of T, NSCC transmits
an index receipt instruction detail report to Members who had activity
on T. The report serves as the contract for the creation/redemption
activity and lists the number of component shares, on a netted basis,
associated with particular creations and redemptions executed on T.
Prior to entering the Corporation's Accounting Operation, each index
share instruction is separated into its underlying stock components,
and incorporated into the normal equity clearance and settlement
process. Unsettled positions in index receipts and their component
securities are risk managed as ordinary activity and guaranteed
pursuant to the provisions of Addendum K.
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    \5\ In 2008, NSCC expanded its index receipt processing to allow
for creates and redeems using cash as the sole underlying component.
This allows Members and their agent banks to create and redeem index
receipts whose underlying components are not currently eligible for
processing at NSCC (for example, commodity index receipts). The
index receipt agent would use the cash to purchase the components,
the settlement of which would occur outside of NSCC. See Securities
Exchange Act Release No. 58694 (September 30, 2008), [File No. SR-
NSCC-2008-07].
    \6\ The balancing amount is designed to compensate for any
difference between the net asset value of the index receipt and the
value of the underlying index. Among other reasons, a difference in
value could result from the fact that an index receipt cannot
contain fractional shares of a security. Separately, from time to
time, an Index Receipt Agent may use cash-in-lieu as part of the
cash balancing amount which means it would substitute the cash value
of a component security for a security in the portfolio. For
instance, such a substitution may be made due to difficulty in
obtaining a particular security. The cash-in-lieu designation is not
used where cash is the sole underlying component of a creation or
redemption.
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    Pursuant to the proposed Rule change, creation/redemption index
receipt activity will no longer be netted prior to the general netting
associated with NSCC's Accounting Operation, and thus will not appear
on the Index Receipt Detail Report as netted, but will be reported in
gross. The discontinuation of this ``pre-netting'' practice will
harmonize NSCC's processing for ETFs with the processing of other
transactions that enter the Accounting Operation which are not netted
prior to entering the Accounting Operation. In addition, the reporting
of the underlying components for creations and redemptions in gross
will better facilitate Members' internal

reconciliation processes by providing a comprehensive view of their
activity prior to it entering the net. The proposed change will not
have a substantive impact on Members or the Corporation, either
operationally or from a risk perspective, as a Member's overall
positions are mathematically the same, and margined equally, regardless
of the whether a Member's create/redeem positions are separately netted
prior to processing in the Accounting Operation. (Note: Included in
NSCC's fee schedule, as set forth in Addendum A to the Rules, is an
``into the net'' charge which is volume based in terms of the dollar
value of the transactions entering the Corporation's Accounting
Operation. In this regard, the proposed change may have an impact on
Member billing in that a gross rather than net transaction value for
creations and redemptions will be fed into the Accounting Operation.)
    In addition, NSCC proposes certain technical corrections and
clarifications to the Section G of Procedure II, including to:
    (a) Highlight the distinction between cash used as the sole
underlying component versus as a partial replacement for underlying
components,
    (b) Indicate, consistent with the change to eliminate the ``pre-
net'' of index receipts, that the Index Receipt Detail Report will
report securities components for a given index receipt transaction in
gross,
    (c) Make a correction to reflect that the Corporation reports to
Members on the Index Receipt Detail Report the details of the creations
and redemptions submitted on T rather than T+1,
    (d) Clarify that the Index Receipt Detail Report also shows the
quantity of index receipt shares associated with the current creation
and redemption activity, and
    (e) Delete an incorrect reference that the Index Receipt Detail
Report provides the total quantity of securities to be delivered and
received on Settlement Date.\7\
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    \7\ Quantities of all securities to be delivered and received by
a Member on Settlement Date (not only with respect to index
receipts) are reported to Members on the Consolidated Trade Summary.
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    Implementation timeframe:
    NSCC proposes to implement the changes set forth in this filing in
the third quarter of 2012. Members will be advised of the
implementation date through the issuance of an NSCC Important Notice.
    The proposed rule change facilitates the prompt and accurate
clearance and settlement of securities transactions by harmonizing the
processing of creates and redeems of index receipts with other NSCC
activity and enhancing Members' abilities to reconcile such activity,
as described above; and is therefore consistent with the requirements
of the Act and the rules and regulations thereunder applicable to NSCC.
The proposed rule change is consistent with the Principles for
Financial Market Infrastructures as it promotes clarity in the Rules
with respect to the reporting of contracts and input into the
Corporation's Accounting Operation.

(B) Self-Regulatory Organization's Statement on Burden on Competition

    NSCC does not believe that the proposed rule change will have any
impact, or impose any burden, on competition.

(C) Self-Regulatory Organization's Statement on Comments on the
Proposed Rule Change Received From Members, Participants or Others

    Written comments relating to the proposed rule change have not yet
been solicited or received. NSCC will notify the Commission of any
written comments received by NSCC.

III. Date of Effectiveness of the Proposed Rule Change and Timing for
Commission Action

    The foregoing rule change has become effective upon filing pursuant
to Section 19(b)(3)(A)(iii) \8\ of the Act and Rule 19b-4(f)(4) \9\
thereunder. At any time within 60 days of the filing of the proposed
rule change, the Commission summarily may temporarily suspend such rule
change if it appears to the Commission that such action is necessary or
appropriate in the public interest, for the protection of investors, or
otherwise in furtherance of the purposes of the Act.
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    \8\ 15 U.S.C. 78s(b)(3)(A)(iii).
    \9\ 17 CFR 240.19b-4(f)(4).
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IV. Solicitation of Comments

    Interested persons are invited to submit written data, views, and
arguments concerning the foregoing, including whether the proposed rule
change is consistent with the Act. Comments may be submitted by any of
the following methods:

Electronic Comments

     Use the Commission's Internet comment form (http://www.sec.gov/rules/sro.shtml) or
     Send an email to<EMAIL_ADDRESS>Please include
File Number SR-NSCC-2012-07 on the subject line.

Paper Comments

     Send paper comments in triplicate to Elizabeth M. Murphy,
Secretary, Securities and Exchange Commission, 100 F Street NE.,
Washington, DC 20549-1090.

All submissions should refer to File Number SR-NSCC-2012-07. This file
number should be included on the subject line if email is used. To help
the Commission process and review your comments more efficiently,
please use only one method. The Commission will post all comments on
the Commission's Internet Web site (http://www.sec.gov/rules/sro.shtml). Copies of the submission, all subsequent amendments, all
written statements with respect to the proposed rule change that are
filed with the Commission, and all written communications relating to
the proposed rule change between the Commission and any person, other
than those that may be withheld from the public in accordance with the
provisions of 5 U.S.C. 552, will be available for Web site viewing and
printing in the Commission's Public Reference Section, 100 F Street
NE., Washington, DC 20549, on official business days between the hours
of 10:00 a.m. and 3:00 p.m. Copies of such filings will also be
available for inspection and copying at the principal office of NSCC
and on NSCC's Web site (http://www.dtcc.com/downloads/legal/rule_filings/2012/nscc/SR-NSCC-2012-07.pdf).
    All comments received will be posted without change; the Commission
does not edit personal identifying information from submissions. You
should submit only information that you wish to make available
publicly. All submissions should refer to File Number SR-NSCC-2012-07
and should be submitted on or before October 10, 2012.

    For the Commission, by the Division of Trading and Markets,
pursuant to delegated authority.\10\
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    \10\ 17 CFR 200.30-3(a)(12).
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Kevin M. O'Neill,
Deputy Secretary.
[FR Doc. 2012-23038 Filed 9-18-12; 8:45 am]
BILLING CODE 8011-01-P


[Federal Register Volume 78, Number 134 (Friday, July 12, 2013)]
[Proposed Rules]
[Page 41907]
[FR Doc No: 2013-16774]

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ENVIRONMENTAL PROTECTION AGENCY

40 CFR Part 423

[EPA-HQ-OW-2009-0819. FRL-9832-7; EPA-HQ-RCRA-2013-0209]
RIN 2040-AF14

Effluent Limitations Guidelines and Standards for the Steam
Electric Power Generating Point Source Category

AGENCY: Environmental Protection Agency (EPA).

ACTION: Proposed rule, extension of public-comment period.

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SUMMARY: The EPA is extending the period for providing comments on the
proposed rule entitled, ``Effluent Limitations Guidelines and Standards
for the Steam Electric Power Generating Point Source Category,''
published in the Federal Register on June 7, 2013, by 45 days.

DATES: Comments. The public-comment period for the proposed rule
published June 7, 2013, (78 FR 34432) is being extended by 45 days to
September 20, 2013, in order to provide the public additional time to
submit comments and supporting information.

ADDRESSES: Comments. Written comments on the proposed rule may be
submitted to the EPA electronically, by mail, by facsimile or through
hand delivery/courier. Please refer to the proposal (78 FR 34432) for
the addresses and detailed instructions.
    Docket. Publically available documents relevant to this action are
available for public inspection either electronically at http://www.regulations.gov or in hard copy at the Water Docket in the EPA
Docket Center, EPA/DC, EPA West, Room 3334, 1301 Constitution Ave. NW.,
Washington, DC. The Public Reading Room is open from 8:30 a.m. to 4:30
p.m., Monday through Friday, excluding legal holidays. The telephone
number for the Public Reading Room is<PHONE_NUMBER>, and the telephone
number for the Water Docket is<PHONE_NUMBER>. The EPA has established
the official public docket No. EPA-HQ-OW-2009-0819.

FOR FURTHER INFORMATION CONTACT: For technical information, contact
Jezebele Alicea-Virella, Engineering and Analysis Division, Telephone:
202-566-1755; Email<EMAIL_ADDRESS>For economic information,
contact James Covington, Engineering and Analysis Division, Telephone:
202-566-1034; Email<EMAIL_ADDRESS>
SUPPLEMENTARY INFORMATION:

Comment Period

    In response to requests from stakeholders, the EPA is extending the
previously announced public-comment period by 45 days. The public-
comment period will end on September 20, 2013, rather than August 6,
2013.

List of Subjects in 40 CFR Part 423

    Environmental protection, Electric power generation, Power plants,
Waste treatment and disposal, Water pollution control.

    Dated: July 3, 2013.
Ellen Gilinsky,
Acting Assistant Administrator.
[FR Doc. 2013-16774 Filed 7-11-13; 8:45 am]
BILLING CODE 6560-50-P


[Federal Register Volume 81, Number 146 (Friday, July 29, 2016)]
[Notices]
[Pages 50035-50036]
[FR Doc No: 2016-18020]

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SECURITIES AND EXCHANGE COMMISSION

[Release No. 34-78417]

Order Granting Application of Investors' Exchange LLC for a
Limited Exemption from Exchange Act Rule 10b-10(a)(2)(i)(A) pursuant to
Rule 10b-10(f)

July 26, 2016.

I. Introduction

    By letter dated July 19, 2016 (``the Application''), Investors'
Exchange LLC (``IEX'' or the ``Exchange'') requests a limited exemption
from the requirements of Rule 10b-10(a)(2)(i)(A) under the Securities
Exchange Act of 1934 (``Exchange Act'') on behalf of Members \1\ that
execute trades on the Exchange for their customers. As discussed in the
Application, IEX will operate a fully automated electronic order book
with a continuous, automated matching function that will provide for
strict price-display-time priority execution (``Trading System'').\2\
The order book and the Exchange's rules provide for post trade
anonymity through settlement for trades executed through IEX.\3\
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    \1\ Unless otherwise defined in this order, defined terms used
have the same meaning as described in the Exchange Rules.
    \2\ See IEX Rule 11.220. IEX represents that the Exchange's
rules do not provide for any special order type that would be an
exception to the strict price-display-time priority handling of
orders as set forth in IEX Rule 11.220.
    \3\ As explained in the Application, the Exchange does not
request an exemption from Rule 10b-10(a)(2)(i)(A) for when it
reveals the identity of a Member or a Member's clearing firm: (i)
For regulatory purposes or to comply with an order of a court or
arbitrator; or (ii) when a Registered Clearing Agency (such as the
National Securities Clearing Corporation) ceases to act for a Member
or the Member's clearing firm, and determines not to guarantee the
settlement of the Member's trades. See IEX Rule 11.250(d)(2).
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II. Background \4\
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    \4\ Background information is derived from the Application.
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a. The Exchange

    IEX is registered as a national securities exchange under Section 6
of the Exchange Act.\5\ The Members of the Exchange consist of those
broker-dealers admitted to Membership and entitled to enter orders in,
and receive executions through, the Exchange's order book or otherwise.
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    \5\ See In the Matter of the Application of: Investors'
Exchange, LLC for Registration as a National Securities Exchange;
Findings, Opinion, and Order of the Commission, Exchange Act Release
No. 78101 (June 17, 2016), 81 FR 41141 (June 23, 2016).
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    The Exchange will operate an order book for orders with a
continuous, automated matching function, in compliance with the
Exchange's rules and Regulation NMS under the Act.\6\ Liquidity will be
derived from orders to buy and orders to sell submitted to the Exchange
electronically by its Members from remote locations.
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    \6\ See 17 CFR 242.600 et seq.
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    The order book and the Exchange's rules will provide for strict
price-display-time priority execution. Under IEX Rule 11.220, orders
will be prioritized on a strict price-display-time basis, first by
price, then by display (with displayed orders and displayed portions of
orders having precedence over non-displayed orders and non-displayed
portions of orders at a given price) and then by time. Incoming orders
are first matched for execution against orders in the IEX order book.
Orders that cannot be executed are eligible for routing to away trading
centers, if consistent with the terms of the orders.\7\ All trades will
be executed through the Exchange's Trading System on an anonymous
basis. The transaction reports produced by the Trading System will
indicate the details of transactions executed in the Trading System but
shall not reveal the contra party identities. Transactions executed in
the Trading System will also be cleared and settled anonymously.\8\
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    \7\ See IEX Rule 11.230. The Exchange understands that the
exemptive relief would not apply to any situation in which the
Trading System routes an order to an away trading center for
execution, as such executions would be governed by the rules of the
away trading center.
    \8\ Except for the conditions set forth in IEX Rule
11.250(d)(2). See supra note 3.
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    The order book's matching system algorithm permits orders
originated by an IEX Member to execute against other orders from the
same participant on the same basis as orders from other Members. In the
order book's handling of displayed orders, which is based on strict
price-display-time priority, a Member could receive an execution
against itself, and under the Exchange's Rules, the Member would not
know that it was the contra-side of the trade at the time of execution.

a. Rule 10b-10

    Rule 10b-10 under the Exchange Act generally requires broker-
dealers effecting a customer transaction in securities (other than U.S.
savings bonds or municipal securities) \9\ to provide a written
notification to its customer, at or before completion of a securities
transaction, that discloses information specific to the transaction. In
particular, under Rule 10b-10(a)(2)(i)(A), when a broker-dealer acts as
agent for a customer, for some other person, or for both a customer and
some other person, the broker-dealer must disclose ``[t]he name of the
person from whom the security was purchased, or to whom it was sold,
for such customer or the fact that the information will be furnished
upon written request of such customer'' (the ``Contra-Party Identity
Requirement'').
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    \9\ Municipal securities are subject to the transaction
confirmations requirements under Rule G-15 of the Municipal
Securities Rulemaking Board.
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III. Relief Sought

    As explained in the Application, trades are executed with total
anonymity on IEX, where the identity of the actual contra-party is not
revealed

when the trade is executed.\10\ Because of this, Members will not know
the identity of the party to whom they sold securities or from whom
they purchased securities. Without this information, Members would not
be able to comply with the Contra-Party Identity Requirement of Rule
10b-10. To permit IEX Members to utilize the Exchange without violating
Rule 10b-10 under the Exchange Act, on behalf of its Members, is
seeking an exemption under Rule 10b-10(f) from the Contra-Party
Identity Requirement of Rule 10b-10 when Members execute transactions
at IEX, as described in the Application.
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    \10\ Except for the conditions set forth in IEX Rule
11.250(d)(2). See supra note 3.
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IV. Conclusion

    Based on the facts and representations contained in the
Application, we find that it is appropriate and in the public interest
and consistent with the protection of investors to grant the Exchange,
on behalf of its Members, a limited exemption from the Contra-Party
Identity Requirement in Rule 10b-10(a)(2)(i)(A).
    IT IS HEREBY ORDERED, pursuant to Rule 10b-10(f) of the Exchange
Act, that IEX Members, based on the representations and facts contained
in the Application, are exempt from the requirements of Rule 10b-
10(a)(2)(i)(A) of the Exchange Act, to the extent that Members execute
trades for their customers on the Exchange using the IEX Trading
System. This exemption is limited to trades that Members execute on IEX
using the post trade anonymity feature described in the
Application.\11\
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    \11\ This exemption does not apply: (a) To orders routed to an
away trading center for execution; (b) under the circumstances
described in note 3 supra; or (c) if the functionality of IEX's
order book were to be changed to allow a broker-dealer to select or
influence against whom its orders will be executed as described in
the Application on page 5 and note 10.
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    The foregoing exemption is subject to modification or revocation if
at any time the Commission determines that such action is necessary or
appropriate in furtherance of the purposes of the Exchange Act.

    For the Commission, by the Division of Trading and Markets,
pursuant to delegated authority.\12\
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    \12\ 17 CFR 200.30-3(32).
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Robert W. Errett,
Deputy Secretary.
[FR Doc. 2016-18020 Filed 7-28-16; 8:45 am]
 BILLING CODE 8011-01-P


NCS Herald Cohort Study Instrument # 13 Female ( enrolled during pregnancy) Questionnaire First Trimester Home Visit Eligibility: All women enrolled while pregnant Mode of administration: Interviewer, home visit 8/ 9/ 2005 Public reporting burden for this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: Dr. Pauline Mendola, US EPA, MD 58A, Research Triangle Park, NC 27711. E mail: mendola. pauline@ epa. gov. Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

2 PRELOADED DATA:

Today's date Language of interview ( English/ Spanish)

Respondent Name Respondent Address and Phone Spouse/ Partner's Name Spouse/ Partner's Address and Phone Biological father's name Marital status Baby due date OB/ GYN name Hospital planning to deliver QUESTIONNAIRE: Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

3 Address ( update)

1. I'd just like to quickly confirm the contact information we have on file: { FILL PRELOADED ADDRESS AND PHONE NUMBER}. Is this still correct?

1 YES 2 NO

Enter correct information 2. Do you plan to move from this address before you have your baby?

1 YES 2 NO

SKIP TO END 3. Where do you plan to move? ( Interviewer: collect complete address if possible. If unknown, collect city and state.)

IF MOVING WITHIN STUDY AREA, ADMINISTER INSTRUMENT # 29, NEW HOME LOCATION IF MOVING OUT OF STUDY AREA, INELIGIBLE. SKIP TO END { END OF ADDRESS MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

4 Partner ( update)

1. When we last interviewed you, you said you were [ FILL MARITAL STATUS FROM SCREENER]. Is this still correct?

1 YES

SKIP TO Q5 2 NO 2. What is your current marital status?

1 Married 2 Widowed

GO TO NEXT MODULE 3 Divorced

GO TO NEXT MODULE 4 Separated

GO TO NEXT MODULE 5 Living with a partner in a committed relationship 6 In a committed relationship, but not living together 7 Single, never married

GO TO NEXT MODULE 3. What is your [ husband's/ partner's] name?

COLLECT HUSBAND/ PARTNER NAME

IF Q2= 6, GO TO Q4. ELSE, GO TO NEXT MODULE REFUSED

SKIP TO END 4. [ THIS IS ONLY ASKED IF Q2= 6] In order to determine if your partner would also like to participate in the study, we would like to collect some contact information. What is your partner's address and telephone number?

COLLECT PARTNER CONTACT INFO

GO TO NEXT MODULE REFUSED

GO TO NEXT MODULE 5. I would like to verify the information you gave me the last time we interviewed you. I have your [ husband's/ partner's] name as [ PRELOAD NAME]. Is this still correct?

1 YES

GO TO NEXT MODULE 2 NO  9 REFUSED 6. Please give me your [ husband's/ partner's] name and address.

COLLECT INFORMATION ON NEW PARTNER REFUSED { END OF PARTNER MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

5 Household Composition ( Full)

The next few questions are about people living in this household.

1. Including yourself, how many adults ages 18 and older are currently living in this household? ( ENTER NUMBER)

_____

2. [ IF Q1> 1] Not including yourself, who are the other adults living in this household? ( PROMPT: HOW ARE THEY RELATED TO YOU?) ( CODE ALL THAT APPLY)

1 your spouse or partner 2 your parent( s) 3 your partner's parent( s) 4 your adult child / children 5 other relation( s) of yourself 6 other relations of your partner 7 roommate( s) 8 boarder or renter 9 other ( SPECIFY) ___________________

3. How many children aged 5 through 17 are currently living in this household? ( ENTER NUMBER)

_____

4. How many children under age 5 are currently living in this household? ( ENTER NUMBER)

_____

5. [ IF Q1 > 1] Are you the regular caregiver for any adults or children who live in this household?

1 YES 2 NO

GO TO NEXT MODULE 6. How many adults do you regularly care for? ( ENTER NUMBER)

_____

7. [ IF Q3+ Q4 > 1] How many children do you regularly care for? ( ENTER NUMBER)

_____

{ END OF HOUSEHOLD COMPOSITION MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

6 Pregnancy Status ( Update, Revised for pregnancy)

1. [ IF OB/ GYN NAME PRELOADED, ASK] Is your obstetrician still [ FILL PRELOAD NAME]?

1 YES

SKIP TO Q3 2 NO 2. What is the name of your OB/ GYN doctor?

DO NOT HAVE A DOCTOR YET REFUSED SPECIFY NAME _______________________________

3. [ IF DELIVERY HOSPITAL PRELOADED ASK] Do you still plan on having your baby at [ FILL HOSPITAL NAME]?

1 YES

SKIP TO END 2 NO 4. Where do you plan to deliver?

1 DON'T KNOW 2 REFUSED 3 SPECIFY HOSPITAL _______________________________ 4 OTHER ( SPECIFY) _______________________________

5. What is your due date?

MM/ DD/ YYYY DON'T KNOW

What was the first day of your last menstrual period? MM/ DD/ YYYY { END OF PREGNANCY STATUS MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

7 Occupation ( Full, revised for pregnancy)

Next, I'm going to ask you about your education and employment.

1. Are you currently a full or part time student?

1 NO, NOT A STUDENT

SKIP TO Q3 2 YES, FULL TIME STUDENT 3 YES, PART TIME STUDENT 2. What type of school are you currently attending?

1 HIGH SCHOOL 2 TECHNICAL SCHOOL 3 COLLEGE OR UNIVERSITY 4 GRADUATE SCHOOL 5 PROFESSIONAL SCHOOL ( FOR EXAMPLE, MEDICAL SCHOOL) 6 OTHER ( SPECIFY)_________________

3. Are you currently

1 Working at a job or business,

SKIP TO PARAGRAPH BEFORE Q5 2 Looking for work, or 3 Not working at a job or business?

4. Were you working at a job or business at any time during the last 12 months?

1 YES 2 NO

SKIP TO END Now, I'd like to ask you a few questions about jobs you held in the last year. I will collect information on your last 3 jobs, if they occurred in the last 12 months. Let's start with your ( FILL: current/ most recent/ next) job.

5. On what date did you start this job?

MM/ DD/ YYYY 6. [ SKIP AND PREFILL WITH ` 1' IF CURRENT JOB] On what date did you stop working at this job?

MM/ DD/ YYYY 1 = STILL EMPLOYED 7. What kind of business or industry ( FILL: is/ was) this? ( For example: TV and radio management, retail shoe store, state labor department, farm.)

_________________________________ ENTER NAME OF BUSINESS, JOB, OR INDUSTRY Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

8 8. What kind of work ( FILL: are/ were) you doing? ( For example: farming, mail clerk, computer specialist.)

_________________________________ ENTER NAME OF OCCUPATION 9. How many hours a week ( FILL: do/ did) you usually work at this job?

____ HOURS 10. ( FILL: Do/ Did) you do shift work for this job?

1 YES 2 NO

SKIP TO Q12 11. ( FILL: Does/ Did) this include the night shift?

1 YES 2 NO 12. Did you have any another jobs in the last 12 months?

1 YES [ REPEAT Q5 Q11 FOR UP TO 3 JOBS THEN GO TO Q13] 2 NO

GO TO Q13 13. Did you stop working at any job, even temporarily, because of your pregnancy?

1 YES 2 NO

SKIP TO END 14. Did you stop working for any of these reasons? ( CODE ALL THAT APPLY) 1 doctor recommended it 2 didn't feel well enough 3 decided not to work 4 other medical reason 5 family encouraged you to quit 6 non family encouraged you to quit 7 some other reason ( SPECIFY) _______________

{ END OF OCCUPATION MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

9 Chemical Exposures Module Now I'm going to ask you about chemicals you may have used at work, at home, or for any hobbies.

1. Have you been exposed to [ HAND SHOW CARD TO R FOR EACH EXPOSURE FROM TABLE BELOW] in the last 12 months?

If Yes, ASK:

2. Are you currently exposed to [ INSERT EXPOSURE] YES NO

SKIP TO NEXT EXPOSURE 3. How often are you exposed to [ INSERT EXPOSURE] ? Would you say. . .

4. Did the exposure occur while you were at work?

1. Exposed in last 12 months Yes= 01 No = 02 2. Currently Exposed Yes = 01 No = 02 3. Frequency 1 = Daily 2 = 2 3/ week 3 = 1/ week 4 = 1/ month 5 = < 1/ month 4. At work Yes = 01 No = 02 A. Fuels, solvents, dry cleaning fluids, degreasers, or adhesives B. Lead, including paints with lead in them C. Fumes or gases ( e. g., nitrous oxide, ethylene oxide, anesthetic gases) D. Radiation ( e. g., fluoroscopy, radioisotopes, highintensity microwaves, x rays) E. Mercury F. Metal fumes or particles G. Pesticides that you've mixed or applied H. Paints, strippers, or varnishes I. Hair and nail products ( e. g, hair dye, bleach, hair relaxer, nail polish and remover) J. Cleaning products ( e. g., oven cleaner, disinfectant, carpet cleaner, bleach) K. Carbon black from copying machines L. Coal or coal products from hot asphalt, tar, or roofing material { END OF CHEMICAL EXPOSURES MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

10 Home Environment/ Conditions ( Full)

The next series of questions are related to your home environment, including your water sources, heating, and air conditioning.

1. How long have you lived at this address: { FILL PRELOAD ADDRESS}?

______ YEARS _______ MONTHS 2. Which water source is used more than half the time for cooking?

1 Tap water 2 Bottled water, or 3 Water from some other source? ( SPECIFY) __________________

3. Which water source is used more than half the time for drinking?

1 Tap water 2 Bottled water, or 3 Water from some other source? ( SPECIFY) __________________

4. Do you use any of the following to treat your water at home? ( CODE ALL THAT APPLY)

1 A water softener? 2 Charcoal filters? 3 Reverse osmosis? 4 Distillation? 5 Something else? ( SPECIFY)_______________________

Heat and Air Conditioning 1. Which fuels are used for heating this residence? ( CODE ALL THAT APPLY)

1 Gas: from underground pipes serving the neighborhood 2 Gas: bottled, tank, or LP 3 Electricity 4 Fuel oil, kerosene, etc 5 Coal or coke 6 Wood 7 Solar energy 8 Propane 9 Other fuel ( SPECIFY) ____________________

2. Does this residence have a central heating system with ducts that blow air into most rooms?

1 YES 2 NO 3. During which month do you usually start using heating devices?

_____ Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

11 4. During which month do you usually stop using heating devices?

_____

5. During the months that you use heating devices, do you use portable kerosene heaters in this residence?

1 YES 2 NO

SKIP TO Q7 6. How often do you use your kerosene heater during the heating season?

1 Less than one day a month 2 One to three days per month 3 One or two days a week 4 3 5 days a week 5 More than 5 days a week 7. During the heating season, is a portable or nonvented gas ( non kerosene) heater used in this residence?

1 YES 2 NO

SKIP TO Q9 8. How often do you use a portable or nonvented gas heater during the heating season?

1 Less than one day a month 2 One to three days per month 3 One or two days a week 4 3 5 days a week 5 More than 5 days a week 9. During the heating season, is a wood or coal burning stove or a wood burning fireplace used in this residence?

1 YES 2 NO

SKIP TO Q11 10. How often do you use a wood or coal burning stove or a wood burning fireplace during the heating season?

1 Less than one day a month 2 One to three days per month 3 One or two days a week 4 3 5 days a week 5 More than 5 days a week 11. Is air conditioning ( refrigeration) used to cool this residence?

1 YES 2 NO

SKIP TO NEXT SECTION Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

12 12. Which of the following types of air conditioning units do you use? ( CODE ALL THAT APPLY)

1 Central unit/ units? 2 Window or wall unit/ units? 3 Portable unit/ units?

13. During which month do you usually start using air conditioning to cool this residence?

_____

14. During which month do you usually stop using air conditioning?

_____

Cooking 1. Do you use a gas stove for cooking?

1 YES 2 NO 2. Do you use a gas stove for any other purpose than cooking, for example, drying clothes or heating a room?

1 YES 2 NO Pesticides and Lawn Care Now I'm going to ask you about the use of pesticides and lawn treatments in and around your home.

1. In the past 6 months, were any chemicals used inside this residence for the control of termites, insects, rodents, or other pests?

1 YES 2 NO

SKIP TO Q6 2. In the past 6 months, what rooms in your home were treated with products for the control of termites, insects, rodents, or other pests? ( CODE ALL THAT APPLY)

1 Living room 2 Family room 3 Dining room 4 Kitchen 5 Bathroom( s) 6 Bedroom( s) 7 Other rooms Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

13 3. In the past 6 months, how many times....

a. did a professional exterminator apply these products inside this residence? _______

b. did you apply these products inside this residence? _______

4. In what month were they last used inside this residence?

_____

5. What were the names of the products last used inside this residence?

_________________ _________________ _________________

6. In the past 6 months, were any chemicals used outside this residence for the control of termites, insects, rodents, or other pests?

1 YES 2 NO

SKIP TO Q10 7. In the past 6 months, how many times....

a. did a professional exterminator apply these products outside this residence? _______

b. did you apply these products outside this residence? _______

8. In what month were they last used outside this residence?

_____

9. What were the names of the products last used outside this residence?

_________________ _________________ _________________

10. In the past 6 months, have you had any regular lawn or yard treatments?

1 YES 2 NO

SKIP TO NEXT SECTION 11. Who usually applies these treatments?

1 You, 2 A professional, or 3 Someone else? Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

14 The next few questions are about the general condition of your home.

Renovations and Paint 1. In the last 6 months, which of the following renovations have been performed in this home? ( CODE ALL THAT APPLY)

1 Adding a room? 2 Putting up or taking down a wall? 3 Replacing windows? 4 Refinishing floors? 5 Exterior painting? 6 Interior painting 2. Over the last 6 months, how would you rate the typical condition of the painted surfaces   the walls, trim, etc.   inside this residence? Would you say

1 Excellent, 2 Very good, 3 Fair, or 4 Poor?

Water Damage / Mold 1. Water damage includes water stains on the ceiling or walls, rotting wood, and flaking sheetrock or plaster. This damage may be from broken pipes, a leaky roof or floods. Have you seen any water damage in your home?

1 YES 2 NO 2. Have you seen any mold or mildew on walls or other surfaces other than food, inside your home?

1 YES 2 NO

SKIP TO NEXT SECTION 3. In which rooms have you seen the mold or mildew? ( CODE ALL THAT APPLY)

1 Kitchen 2 Living room 3 Hall/ landing 4 Your bedroom 5 Other bedrooms 6 Bathroom/ toilet { END OF HOME ENVIRONMENT MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

15 Pets and Pests ( Full)

Now I'm going to ask you a few questions about pets in the household.

1. Do you have house pets such as dogs, cats, gerbils, hamsters, rabbits, guinea pigs or birds?

1 YES 2 NO

SKIP TO Q6 2. How many of the following pets do you have? [ READ EACH TYPE OF PET. IF 1 OR MORE, ASK:

3. [ FILL: Is this pet / How many of these pets are] kept indoors?

Total Number Number kept indoors 1. dogs 2. cats 3. gerbils, hamsters and guinea pigs 4. rabbits 5. birds 6. Other pets ( specify) ____________

4. Are any chemicals used on the pets to control fleas and ticks? ( e. g. treated collars, dips, powders, drops, etc.)

1 YES 2 NO

SKIP TO Q6 5. What is the name of the products last used on your pets to control fleas or ticks?

IF RESPONDENT DOES NOT KNOW, ASK TO SEE THE CONTAINERS _____________________ _____________________

6. In the last 6 months, have you seen signs of mice, rats, or other rodents in your home ( not including pets)?

1 YES 2 NO 7. In the last 6 months, have you seen cockroaches in your home?

1 YES 2 NO { END OF PETS AND PESTS MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

16 Personal and Family Medical History ( Full, revised for pregnancy)

Now I'd like to ask you some questions about your general health.

1. Are you allergic to  ( CODE ALL THAT APPLY)

1 cats? 2 pollen? 3 dust? 4 insect bites or stings? 5 any foods? ( SPECIFY) 6 anything else? ( SPECIFY) __________________

2. Have you ever had a condition called " hayfever" or an allergy that makes your nose runny or stuffy or your eyes itchy when you do not have a cold?

1 YES 2 NO

SKIP TO Q4 3. Did a doctor or other medical provider ever say that this was hayfever or allergy?

1 YES 2 NO 4. Did a doctor or other medical provider ever tell you that you had a skin allergy or eczema?

1 YES 2 NO 5. Did a doctor or other medical provider ever tell you that you had asthma?

1 YES 2 NO

SKIP TO Q8 6. In the past 6 months, have you used any inhalers or taken any pills for asthma or wheezing or whistling in your chest?

1 YES 2 NO 7. Have you ever gone to an emergency room or stayed overnight in a hospital for your asthma?

1 YES 2 NO 8. Some women experience several days or weeks of nausea or feeling sick to their stomach when they are pregnant while other women do not. Have you had any times when you had a feeling of nausea during this pregnancy?

1 YES 2 NO

SKIP TO Q12 Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

17 9. Did your nausea cause you to: [ read choices and circle all that apply]

1. eat less food than you usually did before you were pregnant 2. not be able to do your normal daily activities 3. not be able to take your prenatal vitamin 0. none of the above 10. Have you vomited during this pregnancy because of nausea related to being pregnant?

1 YES 2 NO

SKIP TO Q12 11. Have you vomited more than 4 times in a week for at least one week during this pregnancy?

1 YES 2 NO 12. Do you have any of the following health problems? ( CODE ALL THAT APPLY)

1 High blood sugar ( diabetes) that started before this pregnancy 2 High blood sugar ( diabetes) that started during this pregnancy 3 Vaginal bleeding or spotting 4 Kidney or bladder ( urinary tract) infection 5 Severe nausea, vomiting, or dehydration 6 High blood pressure or hypertension that started before this pregnancy 7 High blood pressure or hypertension that started during this pregnancy ( including pregnancy induced hypertension [ PIH], preeclampsia, or toxemia) 8 High cholesterol 9 Anemia ( poor blood, low iron) 10 Heart problems 11 Asthma 13. Have you ever been diagnosed with any other serious illnesses that I haven't asked about?

1 YES 2 NO

SKIP TO Q14 13a. What were those illnesses? ( ENTER VERBATIM)

_______________________

14. During the past 6 months, have you been hospitalized overnight for any reason ( other than for delivering your baby)?

1 YES 2 NO

SKIP TO Q15 14a. Why were you hospitalized? ( ENTER VERBATIM)

_______________________ Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

18 15. Have any of your blood relatives   your mother, father, sisters or brothers   ever had  ( CODE ALL THAT APPLY)

1 High blood pressure or hypertension? 2 High blood sugar or diabetes? 3 High cholesterol? 4 Heart problems?

{ END OF PERSONAL AND FAMILY MEDICAL HISTORY MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

19 Dental Health ( Full)

7. Have you ever been to the dentist for a routine cleaning?

1 YES 2 NO

SKIP TO Q3 8. When was your last routine cleaning?

MM/ YYYY 9. Do you currently have any of the following dental problems?

[ READ EACH CATEGORY]

IF YES, ASK: When was the last time you saw a dentist for this condition?

a. Plaque YES NO MM/ YYYY 0 = NEVER b. Bleeding gums or other gum disease YES NO MM/ YYYY 0 = NEVER c. Tooth decay YES NO MM/ YYYY 0 = NEVER d. Tooth ache YES NO MM/ YYYY 0 = NEVER e. Dentist diagnosed gingivitis YES NO MM/ YYYY 0 = NEVER f. Dentist diagnosed periodontitis YES NO MM/ YYYY 0 = NEVER g. Missing or broken teeth? YES NO MM/ YYYY 0 = NEVER g. Any other dental problems? ( SPECIFY) YES NO MM/ YYYY 0 = NEVER { END OF DENTAL HEALTH MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

20 Medications ( Full)

I'll be asking you about prescription and non prescription medications you are currently taking. If you do not remember the specific names of your medications, I can wait for you to gather them.

1. Are you currently taking any prescription medications?

1 YES 2 NO

SKIP TO Q3 2. Please tell me what prescription medications you are taking. Are you currently taking any

Medication Type IF YES: What is the name of the [ INSERT MED TYPE] you are taking? a. Antibiotics? 1 YES 2 NO b. Allergy medications, antihistamines, or decongestants? 1 YES 2 NO c. Pain Killers? 1 YES 2 NO d. Medications for depression? 1 YES 2 NO e. Medications for asthma? 1 YES 2 NO f. Other prescription medications? 1 YES 2 NO 3. Do you currently take any non prescription, or over the counter, medications on a regular basis?

1 YES 2 NO

SKIP TO END 4. Please tell me which non prescription medications you currently take on a regular basis. Do you take

Medication Type IF YES: How often do you usually take this medication? a. Tylenol ( Acetominophen)? 1 YES 2 NO 1 = Daily 2 = 2 3/ week 3 = 1/ week 4 = 1/ month 5 = < 1/ month b. Advil or Motrin ( Ibuprofen)? 1 YES 2 NO 1 = Daily 2 = 2 3/ week 3 = 1/ week 4 = 1/ month 5 = < 1/ month c. Cough or cold medicine? 1 YES 2 NO 1 = Daily 2 = 2 3/ week 3 = 1/ week 4 = 1/ month 5 = < 1/ month Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

21 d. Allergy medications, antihistamines, or decongestants? 1 YES 2 NO 1 = Daily 2 = 2 3/ week 3 = 1/ week 4 = 1/ month 5 = < 1/ month e. Aspirin? 1 YES 2 NO 1 = Daily 2 = 2 3/ week 3 = 1/ week 4 = 1/ month 5 = < 1/ month f. Other nonprescription medications? ( SPECIFY) 1 YES 2 NO 1 = Daily 2 = 2 3/ week 3 = 1/ week 4 = 1/ month 5 = < 1/ month { END OF MEDICATIONS MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

22 Supplements, Vitamins, Etc. ( Full)

Now I will ask you similar questions about vitamins and supplements you are taking.

1. Are you currently taking any multivitamins such as One a Day, Centrum, or prenatal vitamins?

1 YES 2 NO

SKIP TO Q5 2. How often do you take any multivitamins or prenatal vitamins?

1 Every day 2 4   6 days per week 3 1   3 days per week 4 1   3 days per month 3. Do your multivitamins usually contain minerals such as iron, zinc, etc.?

1 YES 2 NO 4. How long have you been taking multivitamins?

1 Less than 3 months 2 3 months to 1 year 3 More than 1 year 5. Are you currently taking any vitamins, minerals, or supplements other than your multivitamins?

1 YES 2 NO

GO TO NEXT MODULE 6. Do you take any of the following supplements that are not part of a multivitamin? ( INTERVIEWER: HAND SHOW CARD TO RESPONDENT. CODE ALL THAT APPLY)

1 BETA CAROTENE 2 VITAMIN A 3 VITAMIN B 6 OR B COMPLEX 4 VITAMIN C 5 VITAMIN E 6 CALCIUM OR CALCIUM CONTAINING ANTACIDS 7 VITAMIN D, INCLUDING VITAMIN D TAKEN AS PART OF A CALCIUM SUPPLEMENT 8 BREWER'S YEAST 9 COD LIVER OIL 10 COENZYME Q 11 FISH OIL ( OMEGA 3 FATTY ACIDS) 12 FOLIC ACID/ FOLATE 13 GLUCOSAMINE 14 HYDROXYTRYPTOPHAN ( HTP) 15 IRON 16 NIACIN Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

23 17 SELENIUM 18 ZINC 7. Please tell me if you take any of the following herbal or botanical supplements more than once per week. Include only supplements and teas, not use of the herb in food. ( INTERVIEWER: HAND SHOW CARD TO RESPONDENT. CODE ALL THAT APPLY)

1 ALOE VERA 2 BILBERRY 3 CAYENNE 4 CRANBERRY 5 DONG KUAI ( TANGKWEI) 6 ECHINACEA 7 EVENING PRIMROSE OIL 8 FEVERFEW 9 GARLIC 10 GINGER 11 GINKGO BILOBA 12 GINSENG ( AMERICAN OR ASIAN) 13 GOLDENSEAL 14 GRAPESEED EXTRACT 15 KAVA 16 MILK THISTLE 17 SIBERIAN GINSENG 18 ST. JOHN'S WORT 19 VALERIAN 20 OTHER ( SPECIFY)_____________________

{ END OF VITAMINS/ SUPPLEMENTS MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

24 Neighborhood ( Full)

Now I'd like to ask you about the neighborhood you live in.

1. In your opinion, is your neighborhood

1 A very good place to live 2 A fairly good place to live 3 Not a very good place to live, or 4 Not at all a good place to live?

2. How often do people in your neighborhood

Never Rarely Sometimes Often Always DK a. Visit your home? 0 1 2 3 4  1 b. Argue with you? 0 1 2 3 4  1 c. Look after your children? 0 1 2 3 4  1 d. Keep to themselves? 0 1 2 3 4  1 e. Attend religious services? 0 1 2 3 4  1 3. Is your neighborhood

Not at all Sometimes Usually a. Lively? 0 1 2 b. Polluted/ dirty? 0 1 2 c. Friendly? 0 1 2 d. Noisy? 0 1 2 e. Clean? 0 1 2 f. Attractive? 0 1 2 4. Have you ever asked a neighbor  ( CODE ALL THAT APPLY)

1 To help with minor household tasks or repairs? 2 To give you a ride somewhere? 3 To help take care of you or a family member when you are sick? 4 To borrow money? 5 To borrow other items such as food or tools?

5. Do you feel that your neighborhood is

1 Very safe 2 Somewhat safe 3 Somewhat unsafe, or 4 Very unsafe?

6. In your opinion, does your neighborhood have problems with  ( CODE ALL THAT APPLY)

1 Property crimes such as break ins or burglaries? 2 Personal crimes such as muggings or beatings? 3 Violent crimes? 4 Drug dealing? Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

25 7. From where you live, is it relatively easy for you to get to  ( CODE ALL THAT APPLY)

1 stores to get the groceries you need? 2 public parks or recreational facilities? 3 doctor's offices or clinics? 4 your religious institution? 5 your children's schools? [ DISPLAY ONLY IF R HAS CHILD] 6 daycare programs? [ DISPLAY ONLY IF R HAS CHILD]

8. Are you a member of any religious faith?

1 YES 2 NO

GO TO NEXT MODULE 9. How often do you go to a place of worship?

1 At least once a week 2 At least once a month 3 At least once a year 4 Or not at all?

{ END OF NEIGHBORHOOD MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

26 Health Care Access/ Insurance ( Full, revised for pregnancy)

The next few questions are about health care and insurance.

1. Are you covered by health insurance or some other kind of health care plan? Include health insurance obtained through employment or purchased directly as well as government programs like Medicare and Medicaid that provide medical care or help pay medical bills.

1 YES 2 NO

SKIP TO Q3 2. What kind of health insurance or health care coverage do you have? Include those that pay for only one type of service ( nursing home care, accidents, or dental care). Exclude private plans that only provide extra cash while hospitalized. ( INTERVIEWER: USE SHOW CARD)

1 PRIVATE HEALTH INSURANCE PLAN FROM EMPLOYER OR WORKPLACE 2 PRIVATE HEALTH INSURANCE PLAN PURCHASED DIRECTLY 3 PRIVATE HEALTH INSURANCE PLAN THROUGH A STATE OR LOCAL GOVERNMENT PROGRAM OR COMMUNITY PROGRAM 4 MEDICARE 5 MEDI GAP 6 MEDICAID ({ DISPLAY STATE PLAN NAME}) 7 CHIP ( CHILDREN'S HEALTH INSURANCE PROGRAM) 8 MILITARY HEALTH CARE/ VA 9 CHAMPUS/ TRICARE/ CHAMP VA 10 INDIAN HEALTH SERVICE 11 STATE SPONSORED HEALTH PLAN ({ DISPLAY STATE PLAN NAME}) 12 OTHER GOVERNMENT PROGRAM 13 SINGLE SERVICE PLAN ( E. G., DENTAL, VISION, PRESCRIPTIONS)

3. Are you currently on WIC ( The Special Supplemental Nutrition Program for Women, Infants, and Children)?

1 YES 2 NO 4. What kind of place do you usually go to most often when you are sick or need advice about your health?

1 A clinic or health center, 2 A doctor's office or HMO, 3 A hospital emergency room, 4 A hospital outpatient department, or 5 Some other place? Specify: __________________ 6 DOESN'T GO TO ONE PLACE MOST OFTEN 2. About how long has it been since you last saw or talked to a doctor or other health care professional about your own health, not related to your pregnancy? Include doctors seen while a patient in a hospital. Would you say

0 Never, Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

27 1 6 months or less, 2 More than 6 months, but not more than 1 year ago, 3 More than 1 year, but not more than 2 years ago, 4 More than 2 years, but not more than 5 years ago, or 5 More than 5 years ago?

3. Has anyone, such as your health care provider, family, or friends, spoken to you about getting prenatal care during your pregnancy?

1 YES 2 NO 4. Are you now, or do you plan to get, prenatal care during this pregnancy?

1 YES 2 NO

GO TO NEXT MODULE [ Give participant public health brochure about the importance of prenatal care]

5. Where do you plan to go to receive your prenatal care?

1 Hospital clinic 2 Health department clinic 3 Private doctor's office or HMO clinic 4 Other ( SPECIFY) _____________________

{ END OF HEALTH CARE ACCESS/ INSURANCE MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

28 Feelings about pregnancy ( Full)

The next questions are about the time before you got pregnant.

1. Which of the following statements best describes you during the 3 months before you got pregnant?

1 I was trying to get pregnant 2 I wasn't trying to get pregnant or trying to keep from getting pregnant 3 I was trying to keep from getting pregnant but was not trying very hard 4 I was trying hard to keep from getting pregnant 2. Which of the following statements best describes your husband or partner during the 3 months before you got pregnant?

1 He wanted me to get pregnant 2 He partly wanted me to get pregnant and partly wanted me not to get pregnant 3 He didn't care one way or the other whether I got pregnant 4 He didn't especially want me to get pregnant 5 He wanted very much for me not to get pregnant 3. How did you feel when you found out you were pregnant with your new baby? Were you   1 Very unhappy to be pregnant 2 Unhappy to be pregnant 3 Not sure 4 Happy to be pregnant 5 Very happy to be pregnant { END OF PREGNANCY FEELINGS MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

29 Reproductive History ( Full, revised for pregnancy)

Now, I have some questions about your reproductive health and menstrual history. Please remember that your responses will be kept strictly confidential.

Menstrual History 1. How old were you when you had your first menstrual period?

______ YEARS OLD 2. During the 12 months before you were pregnant, what was the average number of days between the first day of bleeding of one period to the first day of bleeding of your next period?

_____ DAYS 99 = TOO IRREGULAR TO KNOW 3. During the 12 months before you were pregnant { FILL IF Q2= 99: and not counting your current or any previous pregnancy}, did you ever go more than 2 months without having a period?

1 YES 2 NO Pregnancy History 4. How many times have you ever been pregnant? ( not counting your current pregnancy)

( INT PROBE: No matter what happened with the pregnancy)

_____ [ IF 0, SKIP TO NEXT MODULE]

4a. Did any of these pregnancies result in a live birth?

1 YES 2 NO

SKIP TO NEXT MODULE 5. Did any of your babies have any birth defects at birth?

1 YES 2 NO 6. Have you ever had a baby that weighed 5 pounds, 8 ounces ( 2.5 kilos) or less at birth?

1 YES 2 NO 7. Have you ever had baby that was born more than 3 weeks before your due date?

1 YES 2 NO { END OF REPRO HISTORY MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

30 Demographics ( Income)

Household income is often used in scientific studies to compare groups of people who are similar. We do some analysis of the data using these groups. Please remember that all the data you provide is held in strict confidence.

1. Do you or your household receive income from ? ( INTERVIEWER: USE SHOW CARD. CODE ALL THAT APPLY)

1. Wages and salaries? 2. Self employment, including business and farm income? 3. Family or friends? 4. Aid such as Temporary Assistance for Needy Families ( TANF), welfare, WIC, public assistance, general assistance, food stamps, or Supplemental Security Income? 5. [ Do you or your household receive income from] Interest bearing checking accounts, savings accounts, IRAs or certificates of deposit, money market funds, treasury notes, bonds, or other investments that earned interest? 6. Dividends received from stocks or mutual funds, or net rental income from property, royalties, estates or trusts? 7. Unemployment benefits? 8. Child support or alimony? 9. Social security, Railroad Retirement, workers' compensation, disability, veteran benefits, or pensions? 10. Any other source? ( SPECIFY)____________________

2. Including all sources of income just mentioned, approximately what is the gross annual income for all members in this household? ( INTERVIEWER: USE SHOW CARD)

1 Less than $ 9,999, 2 $ 10,000  $ 19,999, 3 $ 20,000  $ 29,999, 4 $ 30,000  $ 39,999, 5 $ 40,000  $ 49,999, 6 $ 50,000  $ 74,999, 7 $ 75,000  $ 99,999, or 8 $ 100,000 or more?

3. How many adults depend on this income?

______

4. How many children depend on this income?

______

5. Do you own this house/ apartment, or is it being rented or occupied through some other arrangement?

1 OWN OR BEING BOUGHT 2 RENT 3 OTHER ARRANGEMENT Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

31 6. Do you { FILL: or your spouse/ partner} have any money in savings or checking accounts or other investment accounts? ( INTERVIEWER: IF NECESSARY READ: Please think ONLY about these types of savings for this question.)

1 YES 2 NO 7. Do you { FILL: or your spouse/ partner} have any money in individual retirement accounts such as IRAs or Keoghs? ( INTERVIEWER: IF NECESSARY READ: Please think only about these types of savings for this question, and DO NOT REPORT any savings already reported.)

1 YES 2 NO { END OF DEMOGRAPHICS/ INCOME MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

32 Alcohol ( Full)

The next few questions are about alcohol consumption. A " drink" is a can or bottle of beer, a glass of wine or a wine cooler, a shot of liquor, or a mixed drink with liquor in it. We are not asking about times when you only had a sip or two from a drink.

1. Have you had any alcoholic drinks in the past 2 years?

1 YES 2 NO

GO TO NEXT MODULE 2. Have you had any alcoholic drinks in the past 3 months?

1 YES 2 NO

GO TO NEXT MODULE 3. During the past 3 months, how many alcoholic drinks did you have in an average week? Would you say

1 Less than 1 drink a week, 2 1 to 3 drinks a week, 3 4 to 6 drinks a week, 4 7 to 13 drinks a week, or 5 14 drinks or more a week?

4. During the past 3 months, how many times did you drink 5 alcoholic drinks or more in one sitting? Would you say

1 Never, 2 1 time, 3 2 or 3 times, 4 4 or 5 times, or 5 6 or more times?

5. During the past 3 months, what one type of alcohol did you drink most often?

1 BEER 2 LIQUOR 3 WINE 4 OTHER SPEFICY:_________________

{ END OF ALCOHOL MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

33 Tobacco ( Full)

These next questions are about your use of tobacco products. This includes cigarettes, chewing tobacco, snuff, cigars, and pipe tobacco.

1. During the past 30 days, have you used snuff, dip, or chewing tobacco, even once?

1 YES 2 NO 2. During the past 30 days, have you smoked a cigar or tobacco pipe, even once?

1 YES 2 NO

SKIP TO Q3 2a. How often do you smoke cigars or tobacco pipes?

_____ NUMBER OF TIMES ENTER UNIT 1 DAY 2 WEEK 3 MONTH 3. Have you smoked at least 100 cigarettes in the past 2 years?

1 YES 2 NO

SKIP TO Q7 4. Do you currently smoke cigarettes?

1 YES

SKIP TO Q6 2 NO 5. When did you last stop smoking?

___ MONTH ___ YEAR SKIP TO Q7 Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

34 6. How many cigarettes do you smoke on an average day now? Would you say  [ INTERVIEWER PROBE: ONE PACK IS 20 CIGARETTES]

1 Less than 1 cigarette per day, 2 1 to 5 cigarettes, 3 6 to 10 cigarettes, 4 11 to 20 cigarettes, 5 21 to 40 cigarettes, or 6 41 cigarettes or more?

7. [ IF PARTNER EXISTS ASK:] Does your husband/ partner currently smoke cigarettes?

1 YES 2 NO 8. Not including yourself, how many cigarette smokers live in your home now?

_____

9. About how many hours per day are you in the same room with someone who is smoking cigarettes, cigars, or tobacco pipes?

_____ Hours 999 Less than 1 hour a day 10. Which of the following statements describes the rules about smoking inside your home now?

1 No one is allowed to smoke anywhere inside my home. 2 Smoking is allowed in some rooms or at some times. 3 Smoking is permitted anywhere inside my home.

{ END OF TOBACCO MODULE} Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

35 Acceptability ( To be administered at the end of the home visit)

This study will be able to answer health questions best if we are able to keep people involved in the study. To do this, we would like to get some feedback from you about the study overall and this visit today to help improve the study in the future.

1. Was participating in the visit today convenient for you?

1 YES

SKIP TO Q6 2 NO 2. Did you have to take time off from work to have this interview today?

1 YES 2 NO 3. Did you need to find childcare to have this interview today?

1 YES 2 NO 4. Were there any other major obstacles for you to have this interview today?

1 YES 2 NO

SKIP TO Q6 5. What were they? ( ENTER VERBATIM)

____________________________

6. Why did you decide to participate in this study? ( CODE ALL THAT APPLY)

1 THE STUDY WOULD BENEFIT MYSELF OR MY CHILD 2 CONTRIBUTE TO IMPROVE HEALTH OF CHILDREN AND PREGNANT WOMEN IN THE FUTURE 3 INTERESTING PROJECT TO BE INVOLVED IN 4 CURIOSITY 5 DESIRE TO BELONG TO A GROUP OR COMMUNITY OF SIMILAR PEOPLE 6 DIDN'T FEEL COMFORTABLE SAYING NO 7 OTHER REASON ( SPECIFY)

7. Is there anything that you especially like about participating in this study? ( ENTER VERBATIM)

____________________________

8. Is there anything you especially dislike about participating in this study? ( ENTER VERBATIM)

____________________________

9. Finally, do you have any recommendations as to what we could do differently in the overall study or in these interviews? ( ENTER VERBATIM) Female ( enrolled during pregnancy) first trimester home visit ( Instrument # 13)

36 ____________________________

{ END OF ACCEPTABILITY MODULE}