NAME AND SURNAME:-

RELATIONSHIP to Head of Household.

AGE.

SEX.

MARRIAGE orORPHANHOOD.

BIRTHPLACE and NATIONALITY.

OCCUPATION and EMPLOYMENT.

Information only required in respect of MarriedMen, Widowers and Widows.

State whether“Head” or“Wife,” “Son,”“Daughter,” “Stepson,” orother Relative.“Visitor,”“Boarder,” or“Servant,”

(See InstructionNo 1.)

Inyearsandmonths.For Infantsunder onemonthold write“Under Onemonth.”SeeExamples.

Ifmalewrite“M,”iffemalewrite“F”

For persons aged 15and over write“Single”,“Married,”“Widowed,” or ifmarriage disolved bydivorce write“D.”———— For childrenaged under 15 write“Both Alive”if both parents be alive“Father Dead”if father be dead“Mother Dead” if mother be dead, or“Both Dead” if bothparents be dead

• If born in the UnitedKingdom write thename of the Countyand of the Town or Parish.
• If born outside theUnited Kingdom write the name ofthe Country and ofthe State, Provinceor District, or
• If born at sea, write“At Sea.”

If not born in theUnited Kingdom statewhether Visitor orResident in this Countryandstate also nationalityif born in a foreigncountry e.g.–“British Born”Naturalised BritishSubject,”“French,”“German,”“Russian,”etc.

Personal Occupation.

Employment.

Place of Work.

Number and ages of all living children and step childrenunder 16 years of age, whether enumerated on thisSchedule or not, i.e. whether residing as members ofthis household or elsewhere.

If attending a School of anykind ofEducationalInstitution forthe purpose ofreceivingInstruction write“Whole Time” or“Part Time” asthe case may be.

(See InstructionNo. 2.)

State here the precise branch of Profession, Trade, Manufacture, Service &c. Where the occupation is connected with Trade or Manufacture, the reply should be sufficient to show the particular kind ofWork done stating where applicablethe Material worked on and the Articlemade or dealt in if any.

If retired see Instruction 6; see also instruc–tions 3 to 11 and Examples.

• If working for an Employer state the name andbusiness of the present employer (person, firmcompany or public body) or, if at present outof work, of last employer, adding “out of work.”
• If employing persons for the purposes of businesswrite “Employer.”
• If working on own account and not employingpersons for the purposes of business write “OwnAccount.”

Note—For Domestic Servants and others in privatepersonal service write“Private.”See Instructions 3 to 8, 11 and examples.

Give the address of each person's place ofwork.

For a person with no regular place ofwork write “No fixed place.”

(No entry is required for any person whois retired or out of work.)

Totalnumberundersixteenyears ofage.if nonewrite“None”.

For each child place a X in the columncorresponding to its age.

The number of crosses should be the same asthe number shown in Column (n).