| Schedule No. 1 – Population.
State ________, Incorporated place ________. Ward of city _________;
Unincorporated place
[Name of unincorporated place having 100 or more inhabitants] _______________________.
County _______________. Township or other division of county ________________________.
Block Nos. ___________; Institution [Name of institution and lines
on which entries are made] ____. |
| |
|
| Location: |
| 1. |
Street, avenue, road, etc. |
| 2. |
House number (in cities or towns). |
| |
|
| Household Data: |
| 3. |
Number of household in order of visitation. |
| 4. |
Home owned (O) or rented (R). |
| 5. |
Value of home, if owned, or monthly
rental, if rented. |
| 6. |
Does this household live on a farm?
(Yes or No). |
| 7. |
Name of each person whose usual
place of residence on April 1, 1940, was in this household. Be sure
to include:
-
Persons temporarily absent from house-hold. Write "Ab" after names of such
persons.
-
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.
|
| 8. |
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.. |
| |
|
| Personal Description: |
| 9. |
Sex – Male (M), Female (F). |
| 10. |
Color or race. |
| 11. |
Age at last birthday. |
| 12. |
Marital status – Single (S), Married (M), Widowed
(Wd), Divorced (D). |
| |
|
| Education: |
| 13. |
Attended school or college any time since March
1, 1940. |
| 14. |
Highest grade of school completed. |
| |
|
| Place of Birth: |
| 15. |
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. |
| 16. |
Citizenship of the foreign born. |
| |
|
Residence, April 1, 1935:
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.) |
| 17. |
City, town, or village having 2,500 or more
inhabitants. Enter "R" for all other places. |
| 18. |
County. |
| 19. |
State (or Territory or foreign country). |
| 20. |
On a farm? (Yes or No). |
| |
|
- Persons 14 Years Old and Over –
- Employment Status:
|
-
21.
|
Was this person AT WORK for pay or profit in
private or nonemergency Gov’t. work during week of March 24-30? (Yes or
No). |
| 22. |
If not, was he at work on, or assigned to, public
EMERGENCY WORK (WPA, NYA, CCC, etc.) during week of March 24-30? (Yes or
No).
If neither at work nor assigned to public emergency work. ("No" in
Cols. 21 and 22). |
| 23. |
Was this person SEEKING WORK?
(Yes or No). |
| 24. |
If not seeking work, did he HAVE A JOB, business,
etc.? (Yes or No). |
| 25. |
Indicate whether engaged in home house-work
(H), in school (S), unable to work (U), or other (Ot). |
| 26. |
Number of hours worked during week of March
24-30, 1940.
If seeking work or assigned to public emergency work. ("Yes" in Col.
22 or 23). |
| 27. |
Duration of unemployment up to March 30, 1940
– in weeks. |
| |
|
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. |
| 28. |
Occupation: Trade, profession, or particular
kind of work, as frame spinner, salesman, rivet heater ,music teacher. |
| 29. |
Industry: Industry or business, as cotton
mill, retail grocery, farm, shipyard, public school. |
| 30. |
Class of worker. |
| 31. |
Number of weeks worked in 1939 (Equivalent full-time
weeks). |
|
|
Income in 1939
(12 months ended December 31, 1939): |
| 32. |
Amount of money wages or salary received (including
commissions). |
| 33. |
Did this person receive income of $50 or more
from sources other than money wages or salary (Yes or No). |
| 34. |
Number of farm schedule. |
| |
|
| Supplementary Questions 33-50 asked only of
a 5% sample of the population, for persons 14 years old and over. (For
persons enumerated on lines 14 and 29). |
| 35. |
Name. |
| |
|
Place of Birth of Father
and Mother:
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. |
| 36. |
Father. |
| 37. |
Mother |
| 38. |
Language spoken in home in earliest childhood. |
| |
|
Veterans:
Is this person a veteran of the United States military forces; or the
wife, widow, or under-18-year-old child of a veteran? |
| 39. |
If so, enter "Yes." |
| 40. |
If child, is veteran-father dead? (Yes or No) |
| 41. |
War or military service. |
| |
|
| Social Security: |
| 42. |
Does this person have a Federal Social Security
Number? (Yes or No) |
| 43. |
Were deductions for Federal Old-Age Insurance
or Railroad Retirement made from this person’s wages or salary in 1939?
(Yes or No) |
| 44. |
If so, were deductions made from (1) all, (2)
one-half or more, (3) part, but less than half, of wages or salary? |
| |
|
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. |
| 45. |
Usual occupation. |
| 46. |
Usual industry. |
| 47. |
Usual class of worker. |
| |
|
| For all women who are or
have been married: |
| 48. |
Has this woman been married more than once?
(Yes or No) |
| 49. |
Age at first marriage. |
| 50. |
Number of children ever born (do not include
stillbirths). |