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The Census of 1920

Schedule No. 1 ? Population.

State __________, County ________________.

Township or other division of county [Insert proper name and, also, name of class, as township, town, precinct, district, hundred, beat, etc..] _____________________. Name of incorporated place [Insert proper name and, also name of class, as city, village, town or borough] _____________.

Ward of city ________________.

Name of institution [Insert name of institution, if any, and indicate the lines on which the entries are made] _______________________________________.

Enumerated by me on the __ day of ____, 1920, ____________________________,


Place of Abode:

1. Street, avenue, road, etc.

2. House number or farm, etc.

3. Number of dwelling house in order of visitation.

4. Number of family in order of visitation.

5. Name of each person whose place of abode on January 1, 1920, was in this family. Enter surname first, then the given name and middle initial, if any. Include every person living on January 1, 1920. Omit children born since January 1, 1920.

6. Relationship of this person to the head of the family.


7. Home owned or rented.

8. If owned, free or mortgaged

Personal description:

9. Sex.

10. Color or race.

11. Age at last birthday.

12. Single, married, widowed, or divorced.


13. Year of immigration to the United States.

14. Naturalized or alien.

15. If naturalized, year of naturalization.


16. Attended school any time since September 1, 1919.

17. Whether able to read.

18. Whether able to write.

Nativity and Mother Tongue:

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 place of birth and, in addition, the mother tongue.


19. Place of birth.

20. Mother tongue


21. Place of birth.

22. Mother tongue.


23. Place of birth.

24. Mother tongue.

25. Whether able to speak English.


26. Trade, profession, or particular kind of work done, as spinner, salesman, laborer, etc?

27. Industry, business, or establishment in which at work, as cotton mill, dry goods store, farm, etc..

28. Employer, salary or wage worker, or working on own account.

29. Number of farm schedule.