This document appears to be a census record from 1900 containing information about individuals in a household. It includes each person's name, relationship to the head of household, personal details like age, birthplace, occupation, and other demographic information. The document contains instructions for enumerators on how to fill out the form and the types of information being collected for each member of the household.

1. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
16 17 18 19 20 21 22 23 24 25 26 27 28
State: _____________ Enumeration District: __________
County: ________________ Sheet Number: __________
City, township: _______________________________________________ Call Number/URL: _______________________________________ Enumeration Date: ____________________
Linenumber
Location
Street
Housenumber
In Cities
Numberofdwellinghouse
intheorderofvisitation
Numberoffamily,
intheorderofvisitation
Name
of each person whose
place of abode on
June 1, 1900, was
in this family.
Enter surname first, then the given name
and middle initial, if any.
Include every person living on June 1, 1900.
Omit children born since June 1, 1900.
Relation
Relationship
of each person
to the head
of the family.
ColororRace
Sex
Month
Year
Date of
Birth
Personal Description
Ageatlastbirthday
Whethersingle,married,
widowed,ordivorced
Numberofyears
ofpresentmarriage
Motherofhowmany
children
Numberofthese
childrenliving
Place of birth of each person and parents
of each person enumerated. If born in United States, give state or territory.
If foreign birth, give the country.
Place of birth
of this person.
Place of birth of Father
of this person.
Place of birth of Mother
of this person.
Nativity
Citizenship Occupation, Trade, or Profession
of each person TEN YEARS of age
and over.
Education Ownership of Home
Numberofyears
intheU.S.
Yearofimmigration
totheU.S.
Naturalization
Linenumber
Occupation
Monthsnot
employed
Attendedschool
(inmonths)
Canread
Canwrite
Canspeak
English
Ownedor
Rented
Ownedfreeor
mortgaged
Farmorhouse
Numberoffarm
schedule
NOTES:
©The Generations Network 2007 To search the 1900 census online, visit www.ancestry.com Ancestry Census Form 012
For more family history charts and forms, visit www.ancestry.com/save/charts/ancchart.htm
1900 United States Federal Census
NOTES:

2. State: _____________ Enumeration District: __________
County: ________________ Sheet Number: __________
City, township: _______________________________________________ Call Number/URL: _______________________________________ Enumeration Date: ____________________
1910 United States Federal Census
Linenumber
Location
Street,avenue,
road,etc.
Name
of each person whose
place of abode on
April 15, 1910, was
in this family.
Enter surname first, then the given name
and middle initial, if any.
Include every person living on April 15, 1910.
Omit children born since April 15, 1910.
Housenumberorfarm
DwellingNumber
Numberoffamily
inorderofvisitation
Relationship of
this person to
the head of the
family
Sex
Personal Description
ColororRace
Ageatlastbirthday
Whethersingle,married,
widowed,ordivorced
Numberofyears
ofpresentmarriage
Place of birth of each person and parents
of each person enumerated. If born in United States, give state or territory.
If foreign birth, give the country.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32
Linenumber
Whether able to
speak English; or,
if not, give
language spoken.
copyright © 2001 Ancestry.com To search the 1910 census online, visit www.ancestry.com Ancestry Census Form 013
Formorefamilyhistorychartsandforms,visitwww.ancestry.com/save/charts/ancchart.htm
Occupation
Relation
Mother of
how many
children
Numberborn
Numbernow
living
Nativity Citizenship
Place of birth
of this person.
Place of birth of Father
of this person.
Place of birth of Mother
of this person.
YearofimmigrationtotheU.S.
WhethernaturalizedorAlien
Trade or profession of, or
particular kind of work
done by this person.
General nature of industry,
business, or establishment
in which this person works.
Whether an employer,
employee, or working
on own account
Whether
out of
work on
April 15, 1910
If an employee–
Number
of weeks
out of work
during 1909
Whetherable
toread
Whetherable
towrite
Attendedschool
anytimesince
Sept.1,1909
Ownedor
Rented
Ownedfreeor
mortgaged
Farmorhouse
Numberoffarm
schedule
Whetherasurvivor
oftheUnion
orConfederate
ArmyorNavy
Education Ownership of Home
Whetherblind
(botheyes)
Whetherdeaf
anddumb

3. 1920 United States Federal Census
State:_______________________ County:____________________________________ City / Township:_________________________________________________________
Call Number/URL:_ _________________________ Enumeration District:_______________________ Sheet Number: ______________ Enumeration Date: ___________
Ancestry® Census Form 014 To search the 1920 census online. visit www.ancestry.com ©The Generations Network, Inc. 2007
LineNumber
Name of each person whose
place of abode on
January 1, 1920 was
in this family
Place of Abode Relation Tenure Personal Description Citizenship Education
Relationship
of this person
to the head
of the family
Homeownedorrented
Ifowned,freeor
mortgaged
Sex
ColororRace
Ageatlastbirthday
Single,married,
widowedordivorced
Yearofimmigrationto
theUnitedStates
Naturalizedoralien
Ifnaturalized,yearof
naturalization
Attendedschool
anytime
sinceSept.1,1919
Abletoread
Abletowrite
Numberoffamily,
inorderofvisitation
Housenumberorfarm
Dwellingnumber
Street,avenue,
road,etc.
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18
LineNumber
Nativity and Mother Tongue
Place of birth of each person and parents of each person enumerated. If born in the United States, give state or territory.
If foreign birth, give the place of birth, and, in addition, the mother tongue.
Person Father Mother
Place of Birth Mother Tongue
19 20
Place of Birth Mother Tongue
21 22
Place of Birth Mother Tongue
23 24
Occupation
Abletospeakenglish
No.offarmschedule
Trade, profession
or particular kind
of work done
Industry, business
or establishment
of work done
Employer, salary
or wage worker,
or working on
own account
25 26 27 28 29

4. State: _____________ Enumeration District: __________
County: ________________ Sheet Number: __________
City, township: _______________________________________________ Call Number/URL: _______________________________________ Enumeration Date: ____________________
1930 United States Federal Census
Linenumber
PLACE OF ABODE
Street,avenue,
road,etc.
Name
of each person whose place of abode on
April 1, 1930, was in this family
Enter surname first, then the given name
and middle intitial, if any
Include every person living on April 1, 1930. Omit
children born since April 1, 1930.
Housenumber
(incitiesortowns)
Numberofdwelling
houseinorderofvisitation
Numberoffamily
inorderofvisitation
Relation
Relationship of
this person to
the head of the
family
Homeownedorrented
Valueofhome,
ifowned,ormonthlyrental,
ifrented
Radioset
Doesthisfamily
liveonafarm?
Home Data personal description education
Sex
Colororrace
Ageatlastbirthday
Maritalcondition
Ageatfirstmarriage
Attendedschoolor
collegeanytime
sinceSept.1,1929
Whetherabletoread
andwrite
Place of birth of each person and parents of each person enumerated. If born
in the United States, give the State or Territory. If of foreign birth, give the
country of birth. See Instructions for additional entries required for certain
countries
PLACE OF BIRTH
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
21 A B C 22 23 24 25 26 D 27 28 29 30 31 32
Linenumber
MOTHER TONGUE (OR NATIVE
LANGUAGE) OF FOREIGN BORN
Language spoken
in home before
coming to the
United States
CODE
(For office use only.
Do not write in
these columns)
Yearofimmigration
totheUnitedStates
Naturalizedoralien
Whetherabletospeak
English
CITIZENSHIP
State
or M.T
Country
INDUSTRY
Industry or business, as
cottonmill, dry goods store,
shipyard, public school, etc.
OCCUPATION
Trade, profession, or particular
kind of work, as spinner,
salesman, riveter, etc.
CODE
(For office use
only.
Do not
write
in
this
column)
ClassofWorker
EMPLOYMENT
Whether actually
at work
Yes
or
No
Line number
for
unemployed
Yes or
No
VETERANS
Whether a veteran of the
U.S. military or
naval forces mobilized
for any war or
expedition
No.offarm
schedule
What war or
expedition
NOTES:
©The Generations Network 2007 To search the census online, visit www.ancestry.com Ancestry Census Form 015
Formorefamilyhistorychartsandforms,visitwww.ancestry.com/save/charts/ancchart.htm
OCCUPATION AND INDUSTRY
person father mother

5. State Incorporated place Ward of city
County Block Nos.
Unincorporated place
DEPA
SIXTEENT(Name of unicorporated place having 100 or more inhabitants)
(Name of institution and lines on which entries are made)
LOCATIONLineNo.
Street,avenue,road,etc.
Housenumber(incitiesandtowns)
Numberofhouseholdin
orderofvisitation
Homeowned(O)orrented(R)
Sex-Male(M),Female(F)
Colororrace
CODE
(Leaveblank)
Ageatlastbirthday
Valueofhome,ifowned,ormonthly
rental,ifrented
Doesthishouseholdliveonafarm?
(YesorNo)
Name of each person whose usual place of
residence on April 1, 1940, was in this household.
BE SURE TO INCLUDE:
1. Persons temporarily absent from household.
Write “Ab” after names of such persons.
2. Children under 1 year of age. Write “Infant” if child
has not been given a first name.
Enter “X” after name of person furnishing information.
1 2 3 4 5 6 7 8 A 9 10 11 12 13 14 15 16 17 18 19CB
MaritalStatus–
Single(S),Married(M)
Widowed(Wd),Divorced(D)
Attendedschoolorcollegeanytime
sinceMarch1,1940?(YesorNo)
Highestgradeofschoolcompleted
CODE(Leaveblank)
CODE(Leaveblank)
Citizenshipoftheforeignborn
HOUSEHOLD DATA NAME RELATION EDUCATION PLACE OF BIRTH
nlawful
concern
CITI-
ZEN-
SHIP
RESIDENCE, APRIL 1, 1935
PERSONAL
DESCRIPTION
Institution
Township or other
division of county
Relationship of this
person to the head of
the household, as wife,
daughter, father,
mother-in-law,
grandson, lodger,
lodger’s wife, servant,
hired hand, etc.
If born in the United
States, give State,
Territory, or
possession.
If foreign born, give
country in which
birthplace was situated
on January 1, 1937.
Distinguish
Canada-French from
Canada-English and
Irish Free State (Eire)
from Northern Ireland.
STATE (or Territory
or foreign country)
City, town, or village
having 2,500 or more
inhabitants. Enter “R”
for all other places.
IN WHAT PLACE DID THIS PERSON LIVE ON APRIL 1, 1935?
For a person who, on April 1, 1935, was living in the same house as at presen
in Col. 17 “Same house,” and for one living in a different house but in the sam
or town, enter, “Same place,” leaving Cols. 18, 19, and 20 blank, in both inst
For a person who lived in a different place, enter city or town, county, or Sta
mail address.)
COUNTY
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
SUPPL
QUEST.
30
31
32
33
34
35
36
37
38
39
40
14
29
35 36 37 G 38 H 39 40 41 42 43 44 45I
SUPPL
QUEST.
LineNo.
Check,
if household
cont. on
next page
If born in the United States, give State, Territory, or possession
If foreign born, give country in which birthplace was situated on January 1, 1937
Distinguish Canada-French from Canada-English and Irish Free State (Eire) from
Northern Ireland
Where owner’s household
occupies only a part of a
structure, estimate value of
portion occupied by owner’s
household. Thus the value of the
unit occupied by the owner of a
two-family house might be
approximately one-half the total
value of the structure.
White_____________W
Negro_____________Neg
Indian_____________In
Chinese___________Chi
Japanese__________Jp
None _______________________________________ C
8ot,.te,2,1_______edarght8otts1,loohcsyratnemelE
4-H,3-H,2-H,1-H________raeyht4otts1,loohcshgiH
4-C,3-C,2-C,1-C_____________raeyht4otts1,egelloC
5-C_________________raeytneuqesbusroht5,egelloC
Naturalized___
Having first pap
Alien_________
American citize
April 1939_____________ 11/12
May 1939_____________ 10/12
June 1939_____________ 9/12
July 1939______________8/12
August 1939___________ 7/12
September 1939________6/12
October 1939__________ 5/12
November 1939________ 4/12
December 1939________ 3/12
January 1939__________ 2/12
February 1939_________ 1/12
March 1939___________ 0/12
Filipino_____________Fil
Hindu______________Hin
Korean_____________Kor
Other race, spell out in full.
NDUST
ards as h
rmine th
h he is p
ols. 46 a
Language spoken in home in
earliest childhood
Is this person a veteran of the
United States military forces;
or the wife, widow, or under
18-year-old child of a veteran?
CODE(Leaveblank)
CODE
(Leave
blank)
MOTHERFATHER
NAME
SYMBOLS
AND
EXPLANATORY
NOTES
Ifso,enter
“Yes”
Ifchild,is
veteran-father
dead?
(YesorNo)
Warormilitary
service
CODE
(Leaveblank)
Doesthispersonhavea
FederalSocialSecurity
Number?(YesorNo)
WeredeductionsforFed-
eralOld-AgeInsurance
orRailroadRetirement
madefromthisperson’s
wagesorsalaryin1939?
(YesorNo)
Ifso,weredeductions
madefrom(1)all,(2)
one-halformore,(3)part,
butlessthanhalf,of
wagesorsalary?
PLACE OF BIRTH OF FATHER AND MOTHERFor Persons Enumerated on Lines 14 and 29
SUPPLEMENTARY
QUESTIONS
MOTHER TONGUE
(OR NATIVE LANGUAGE)
VETERANS SOCIAL SECURITY
USUAL OCCUPATION USUAL IN
FOR PERSONS OF ALL AGES FOR PERSONS 14 YEARS OLD AND
COL. 5. VALUE OF HOME, IF OWNED: COL. 10. COLOR OR RACE: COL. 11. AGE AT LAST BIRTHDAY: COL. 14. HIGHEST GRADE OF SCHOOL COMPLETED: COL. 16. CITIZENSHI
Enter age of children born on or after April 1, 1939, as follows. Born in:
(Do not include children born on or after April 1, 1940.)
1940UnitedStatesFederalCensus-p.1
directed in the instructions. (Enter actual place of residence, which
USUAL OCCUPATION , INDUST
Enter that occupation which the person regards as h
able to work. If the person is unable to determine th
longest during the past 10 years and at
Enter also usual industry an
For a person without previous work exp
leave Cols. 46 a

6. orated place
DEPARTMENT OF COMMERCE-BUREAU OF THE CENSUS
SIXTEENTH CENSUS OF THE UNITED STATES: 1940
POPULATION SCHEDULE
(Name of unicorporated place having 100 or more inhabitants)
(Name of institution and lines on which entries are made)
15 16 17 18 19 20 D 21 22 23 24 25 E 26 27 28 29 30 F 31 32 33 34
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
SUPPL
QUEST.
30
31
32
33
34
35
36
37
38
39
40
14
29
C
CODE(Leaveblank)
Citizenshipoftheforeignborn
Onafarm?
(YesorNo)
CODE
(Leaveblank)
CODE
ACE OF BIRTH
CITI-
ZEN-
SHIP
RESIDENCE, APRIL 1, 1935 PERSONS 14 YEARS OLD AND OVER–EMPLOYMENT STATUS
n
S. D. No. E. D. No. Sheet No.
Enumerated by me on , 1940 A
, Enumerator.
n the United
give State,
y, or
ion.
n born, give
in which
ce was situated
ary 1, 1937.
uish
-French from
- English and
e State (Eire)
rthern Ireland.
STATE (or Territory
or foreign country)
City, town, or village
having 2,500 or more
inhabitants. Enter “R”
for all other places.
IN WHAT PLACE DID THIS PERSON LIVE ON APRIL 1, 1935?
For a person who, on April 1, 1935, was living in the same house as at present, enter
in Col. 17 “Same house,” and for one living in a different house but in the same city
or town, enter, “Same place,” leaving Cols. 18, 19, and 20 blank, in both instances.
For a person who lived in a different place, enter city or town, county, and State, as
directed in the instructions. (Enter actual place of residence, which may differ from
mail address.)
OCCUPATION, INDUSTRY, AND CLASS OF WORKER
For a person at work, assigned to public emergency work, or with a job (”Yes” in Col. 21,
22, or 24), enter present occupation, industry, and class of worker.
For a person seeking work (”Yes” in Col. 23): (a) IF he has previous work experience, enter
last occupation, industry, and class of worker: or (b) if he does not have previous work
experience, enter “New worker” in Col. 28, and leave Cols. 29 and 30 blank.
WasthispersonATWORKforpayorprofit
inprivateornon-emergencyGovt.work
duringweekofMarch24-30?(YesorNo)
Ifnot,washeatworkon,orassignedto,
publicEMERGENCYWORK(WPA,
NYA,CCC,etc.)duringweekofMarch
24-30?(YesorNo)
Wasthisperson
SEEKINGWORK?
(YesorNo)
If neither at work
nor assigned to
public emergency
work. (”No” in
Cols. 21 and 22)
For persons
answering
“No” to quest. 21,
22, 23, and 24
If at
private or
nonemer-
gency
Government
work. (”Yes”
in Col. 21)
If seeking
work or
assigned to
public
emergency
work. (”Yes”
in Col. 22 or
23)
Durationof
unemploymentup
toMarch30,
1940-inweeks
Numberofhours
workedduring
weekofMarch
24-30,1940
Ifnotseekingwork,
didheHAVEAJOB,
business,etc.?
(YesorNo)
Indicatewhether
engagedinhome
housework(H),in
school(S),unableto
work(U)orother(Ot)
COUNTY
OCCUPATION
Trade, profession, or
particular kind of work, as -
frame spinner
salesman
laborer
rivet heater
music teacher
INDUSTRY
Industry or business, as -
cotton mill
retail grocery
farm
shipyard
public school
CODE
(Leave blank)
Classofworker
NumberofFarmSchedule
LineNo.
Numberofweeksworkedin1939
(Equivalentfull-timeweeks)
Amountofmoneywagesor
salaryreceived
(Includingcommissions)
INCOME IN 1939
(12 months ending
December 31, 1939)
Didthispersonreceive
incomeof$50ormorefrom
sourcesotherthanmoney
wagesorsalary?(YesorNo)
SUPPL
QUEST.
40 41 42 43 44 45 46 47 J 48 49 50 K L M N O P Q R S T U V W X ZYI
Enter “Yes” for persons at work
for pay or profit in private or
nonemergency Goverment work.
Include unpaid family workers -
that is, related members of the
family working without money
wages or salary on work (other
than house work or incidental
chores) which contributed to the
family income.
Enter “Yes” for person (not seeking
work) who had a job, business, or
professional enterprise, but did not
work during week of March 24-30 for
any of the following reason: Vacation;
temporary illness; industrial dispute;
layoff not exceeding 4 weeks with
instructions to return to work at a
specific date; layoff due to temporarily
bad weather conditions.
None _______________________________________ C
8ot,.te,2,1_______edarght8otts1,loohcsyratnemelE
4-H,3-H,2-H,1-H________raeyht4otts1,loohcshgiH
4-C,3-C,2-C,1-C_____________raeyht4otts1,egelloC
5-C_________________raeytneuqesbusroht5,egelloC
Naturalized______________________Na
Having first papers________________Pa
Alien____________________________Al
American citizen born abroad______Am Cit
Wage or salary worker in
private work_____________PW
Wage or salary worker in
Government work________GW
Employer___________________E
Working on own account_____OA
Unpaid family worker________NP
World War__________________W
Spanish-American War,
Philippine Insurrection,
or Boxer Rebellion___________S
Spanish-American War and
World War________________SW
Regular establishment
(Army, Navy, or Marine Corps)
peace-time service only_______R
Other war or expedition_______Ot
______ 5/12
______ 4/12
______ 3/12
______ 2/12
______ 1/12
______ 0/12
USUAL OCCUPATION , INDUSTRY, AND CLASS OF WORKER
Enter that occupation which the person regards as his usual occupation and at which he is physically
able to work. If the person is unable to determine this, enter that occupation at which he has worked
longest during the past 10 years and at which he is physically able to work.
Enter also usual industry and usual class of worker.
For a person without previous work experience, enter “None” in Col. 45 and
leave Cols. 46 and 47 blank.
person a veteran of the
d States military forces;
e wife, widow, or under
r-old child of a veteran?
Ifchild,is
veteran-father
dead?
(YesorNo)
Warormilitary
service
CODE
(Leaveblank)
Doesthispersonhavea
FederalSocialSecurity
Number?(YesorNo)
WeredeductionsforFed-
eralOld-AgeInsurance
orRailroadRetirement
madefromthisperson’s
wagesorsalaryin1939?
(YesorNo)
Ifso,weredeductions
madefrom(1)all,(2)
one-halformore,(3)part,
butlessthanhalf,of
wagesorsalary?
Hasthiswomanbeenmarried
morethanonce?(YesorNo)
Usual
class of
worker
Ageatfirstmarriage
LineNo.
Numberofchildreneverborn.
(Donotincludestillbirths)
Ten
(4)
V-R
(5)
Fm.
res.
and
Sex
(6
and
9)
Color
and
nat.
(10,
15,
56,
and
37)
Age
(11)
Mar.
st.
(12)
Gr.
Com.
(B)
Cit.
(16)
Wrk.
st.
(E)
Wks.
wkd.
(31)
Wages
(32)
Ot.
inc.
(33)
Hrs.
wkd.
or
Dur.
un.
(26
or
27)
Occupation, industry,
and class of worker
(F)
VETERANS SOCIAL SECURITY
USUAL OCCUPATION USUAL INDUSTRY
CODE
(Leave blank)
FOR PERSONS 14 YEARS OLD AND OVER FOR OFFICE USE ONLY - DO NOT WRITE IN THESE COLUMNSFOR ALL WOMEN WHO ARE
OR HAVE BEEN MARRIED
COL. 14. HIGHEST GRADE OF SCHOOL COMPLETED: COL. 16. CITIZENSHIP OF THE FOREIGN BORN: COL. 21. WAS THIS PERSON AT WORK? COL. 24. DID THIS PERSON HAVE A JOB? COLS. 30 AND 47. CLASS OF WORKER: COL. 41. WAR OR MILITARY SERVICE:
Born in:
1940.)
1940UnitedStatesFederalCensus-p.2