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County

Township or other division of county

Name of incorporated city, town, or village, wit

Enumerated by me on the... —---__--

LOCATION. NAME

of each person whose place of
abode on June 1, 1900, was
in this family.

IN CITIES.

Enter surname first, then the given name and
middle initial, if any.

INCLUDE every person living on June 1, 1900.
Omnrt children born since June 1, 1900.

house, fn the order of

visitation,
Number of family, in the
order of visitation

Number of  dwelling-

Howse number.

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TWELFTH CENSUS OF THE UNITED STATES. 4
D>

SCHEDULE No. 1.—POPULA TION. | Supervisor's District No. — 7 |9°
ie INDIAN BOPULATION. we td
all cece Meer, Lp cccay. ~..\ A eaee —- se =

nthe above-named Ra : xe he ee ae Zz ara Sayer one wee Con
13 Lj nal hal - AYN. Enuimerator.

...day of June, 1900, 7

( Enumeration District No.

Name of Institution, —-.

Ward of city, --

crTizESsSuiP. OCCUPATION, TRADE, OR

PROFESSION

of each person TEN YEARS of age
and over.

NATIVITY.

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 only.

RELATION. PERSONAL DESCRIPTION.

DATE OF
BIRTH.

EDUCATION.

OWNERSHIP OF HOME.

0, married,

d

ivorced.

Relationship of each
person to the head

of the family. Place of birth of Motrurr

Place of birth of this Place of birth of Fatnen
of this person.

i OCCUPATION.
Penson. of this person.

(See instructions below.)

Nother of year in the

United States,

Number of years married.

Mother of low many

children,
Number of these children

living,
Year of inimigration to
United States

the U
Attended school (in

Naturalization.

Months tot
employed
months),

widowed, or
Owned fieo or mortgaged,

Whether singl

Can speak English,
Owned or rented,

Farm or louse.

Number of farm schedule,

Can write,

Color or Race.
.@ | Age at last birthday,

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a
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)
a
rd

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1 eh tb S|. 0 pahXelyte Gpehslesie Goh datiree

5 te ae STD ate <-

Historic census records are maintained and released by the National Archives and Records Administration, not the U.S. Census Bureau.

Visit http://www.archives.gov for more information about publicly available records like the one shown here.

KY Mig, (FF Of ML Aj 2 v
fel 1826 79 Te
[a Lev Moo 34 WF

Ul MAW TA. CIE XNA Th. CHCA AST
| H&K firh Pacck LM Pan xJete ah
Cutt Ab rie Ort ctita Cadden

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a
Vtaff

SCHEDULE No. 1.—POPULATION— Continued.
6 SPECIAL INOUIRIES RELATING TO INDIANS.

yee CITIZENSHIP DWELLINGS.

CONJUGAL

NATIVITY. CONDITION.

INSTRUCTIONS FOR FILLING THIS SCHEDULE.

A
This moditied form of Schedule No. 1 is to be used in making the
enumeration of Indians, both those on reservations and those living in
family groups outside of reservations.

Has this Indian any
white blood;
ifs, how much *
(0, 3g, 324. or Bae)

Is this Indian living in a
fixed or in a movable
dwelling?

Is this Indian, if Is this Indian Vear
married, living in taxed? of acquiring
polyzamy? (See instructions.) citizenship.

Was citizenship
acquired
by allotment?

j
Tribe of Faruer of this | Tribe of Motruenr of thi«
Indian. Iudian

Detached Indians living either in white or negro families outside of
reservations should be enumerated on the general population schedule (Form
7-224) as members of the families in which they are found: but detached
whites or negroes living in Indian families should be enumerated on this
schedule as members of the Indian families in which they are found. In
other words, every family composed mainly of Indians should be reported
entirely on this schedule, and every family composed mainly of persons not
Indian should be reported entirely on the general population schedule.

This schedule contains on each side twenty horizontal lines, each run-
ning twice across the page, and it is consequently possible to enumerate on it
only forty persons (twenty persons on the A side and twenty persons on the
B side). Each Indian should be carried through from the beginning to the
end of the line on which he is entered, as line 1, line 2, ete., and each inquiry
from column 1 to column 38 which applies to the individual case should be
answered.

COLUMNS | TO 28.—These columns are identical with those on the general
population schedule. Fill each column, so far as the inquiry applies, in
accordance with the instructions for filling the corresponding columns in the
general population schedule, but note the following additional instructions in
relation to filling columns 1, 2. and 19:

COLUMNS 1 AND 2.—If you are canvassing a given territory with both
the general population schedule (Form 7-224) and this schedule for Indian
population, make two independent series of numbers for these columns, one
series in each kind of schedule, so that the last numbers on the two schedules
when added together will correctly give the whole number of dwellings and
of families visited and enumerated in your entire district.

CoLuMN 19.—If the Indian has no occupation and is wholly dependent
on the Government for support, write ‘* Ration Indian.” If he is partly self-
supporting and partly dependent upon the Government, write the occupation
and then the letter ‘‘R” (for ration). If the Indian is under ten years of
age and receives rations, write ‘* Under age—R.”

INSTRUCTIONS CONTINUED ON “B” SIDE OF SHEET.