Beruflich Dokumente
Kultur Dokumente
concern
10
11
12
13
14
CITIZENSHIP
PLACE OF BIRTH
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.
15
Marital Status
Single (S), Married (M)
Widowed (Wd), Divorced (D)
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.
Relationship of this
person to the head of
the household, as wife,
daughter, father,
mother-in-law,
grandson, lodger,
lodgers wife, servant,
hired hand, etc.
DEPA
SIXTEENT
EDUCATION
Color or race
Number of household in
order of visitation
PERSONAL
DESCRIPTION
RELATION
Institution
CODE
(Leave blank)
NAME
Block Nos.
Line No.
HOUSEHOLD DATA
16
17
COUNTY
18
19
1
2
3
4
5
6
7
8
9
10
11
12
13
SUPPL
QUEST.
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
SUPPL
QUEST.
29
30
31
32
33
34
35
36
37
38
39
40
FOR PERSONS OF ALL AGES
36
37
38
39
40
41
42
CODE
(Leave
blank)
CODE
(Leave blank)
MOTHER
FATHER
SOCIAL SECURITY
War or military
service
NAME
VETERANS
If child, is
veteran-father
dead?
(Yes or No)
35
MOTHER TONGUE
(OR NATIVE LANGUAGE)
If so, enter
Yes
SUPPLEMENTARY
QUESTIONS
For Persons Enumerated on Lines 14 and 29
Check,
if household
cont. on
next page
Line No.
LOCATION
Unincorporated place
Township or other
division of county
County
Ward of city
Incorporated place
State
43
44
NDUST
USUAL OCCUPATION , INDUST
ards as h
Enter that occupation which the person regards
rmine th
able to work. If the person is unable to determine
h he
p
longest during the past 10 years
andisat
Enter also usual industry an
For a person without previous work exp
ols. 46 a
leave Cols.
USUAL OCCUPATION
USUAL IN
45
14
29
COL. 5. VALUE OF HOME, IF OWNED:
SYMBOLS
AND
EXPLANATORY
NOTES
Filipino_____________Fil
Negro_____________Neg
Hindu______________Hin
Indian_____________In
Korean_____________Kor
Chinese___________Chi
Japanese__________Jp
Naturalized___
Alien_________
American citize
, Enumerator.
23
24
25
26
28
29
27
CODE
(Leave blank)
30
31
22
INDUSTRY
Industry or business, as cotton mill
retail grocery
farm
shipyard
public school
32
33
34
Line No.
21
OCCUPATION
Trade, profession, or
particular kind of work, as frame spinner
salesman
laborer
rivet heater
music teacher
INCOME IN 1939
(12 months ending
December 31, 1939)
Did this person receive
income of $50 or more from
sources other than money
wages or salary? (Yes or No)
20
If seeking
work or
assigned to
public
emergency
work. (Yes
in Col. 22 or
23)
Duration of
unemployment up
to March 30,
1940 - in weeks
19
Number of hours
worked during
week of March
24-30, 1940
18
CODE
17
16
COUNTY
CODE
(Leave blank)
If neither at work
For persons
If at
nor assigned to
answering
private or
public emergency No to quest. 21, nonemerwork. (No in
22, 23, and 24
gency
Cols. 21 and 22)
Government
work. (Yes
in Col. 21)
On a farm?
(Yes or No)
15
uish
-French from
- English and
e State (Eire)
rthern Ireland.
n born, give
in which
ce was situated
ary 1, 1937.
, 1940
n the United
give State,
y, or
ion.
Sheet No.
CITIZENSHIP
ACE OF BIRTH
E. D. No.
Enumerated by me on
POPULATION SCHEDULE
S. D. No.
Class of worker
orated place
1
2
3
4
5
6
7
8
9
10
11
12
13
14
SUPPL
QUEST.
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
FOR ALL WOMEN WHO ARE
OR HAVE BEEN MARRIED
42
Born in:
______ 5/12
______ 4/12
______ 3/12
______ 2/12
______ 1/12
______ 0/12
1940.)
43
44
USUAL INDUSTRY
Usual
class of
worker
CODE
(Leave blank)
45
46
47
Ten
(4)
48
49
50
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)
Hrs.
wkd.
or
Dur. Occupation, industry,
and class of worker
un.
(F)
(26
or
27)
Wks.
wkd.
(31)
Wages
(32)
Ot.
inc.
(33)
Line No.
CODE
(Leave blank)
41
USUAL OCCUPATION
War or military
service
40
If child, is
veteran-father
dead?
(Yes or No)
SOCIAL SECURITY
14
29
COL. 14. HIGHEST GRADE OF SCHOOL COMPLETED:
None _______________________________________ C
E l e m e n t a r y s c h o o l , 1 s t t o 8 t h g r a d e_ _ _ _ _ _ _ 1 , 2 , e t . , t o 8
High school, 1st to 4th year_ _ _ _ _ _ _ _ H -1 , H -2 , H -3 , H - 4
College , 1st to 4th year_ _ _ _ _ _ _ _ _ _ _ _ _C-1 , C-2 , C-3 , C- 4
C o l l e g e , 5 t h o r s u b s e q u e n t y e a r_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ C - 5
SUPPL
QUEST.