STATE EPARTMENT OF COMMERCE AND LABOR-BUREAU OF THE CENSUS ( SUPERVISOR'S DISTRICT NO, . A )  Sneer No.

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COUNTY 4 THB TEEN: CENSUS OF THE UNITED STA ES: ps ae OP LATION ( ENUMCRATION DISTRICT No. . Gg FP Ret
TOWNSHIP OR OTHER DIVISION OF COUNTY = ee ies v bu i “pas easeeeeee FO NAME OF INCORPORATED PLACE. AAC: ee PE a ZG LEA falf ¥ ff

[Theert proper paine and, also, name of clas, aac Atte org nn ng ne of class, as city, village, town, « ees "fee tnatruc

oes ENUMERATED BY ME ON THE...“ _— __ pay or _CZ/e4e 4 1910. EY AP ALLA ae “ENUMERATOR,

ot}—~aett NAME OF INSTITUTION...

{Tnmert natae of Institution . tfas y. “nbd [nticate the Ite on which the entries are mala. Sew inettuctions «|

LOCATION, NAME RELATION. PERSONAL DESCRIPTION, NATIVITY. CITIZENSHIP. OCCUPATION, EDUCATION. OWAERSEI? OF BOE.

Place of birth of each person and parents of each poe enumerated. If bors tn the United States,
bow many give the state or territory. If of foreign birth, give the country.

eblldren.

(both

|

i,

of each person whose place of abode on April 15,
1910, was in this family.
HelationahIp of this per-

Enter surname first, then the elven name and — he b t
initial, if any. se lime bcp

Inelade every Zapeaee Brive on 3 St ag H
3 le ‘ ‘
Vowate, +> PY) fan Af fta WW
BU — nae = 4|
iB Lbsrrnt Lon ree ‘

e
a
sc
Z
a
2
a
¢
~

Whether fan employee-

| an Wheth- Nam-
lemployer,fer out ber of
employer.) of werks

Wheth b
Engliehs ney Rayer Trade or profession of, or | General natare of Indastry,

trel kes. particular kind of work | business, or establishment
Hive engeageapence done by this person, as | = Inwhich this person works, ped work | ont of
epinner, ealerman, la- Ss rufton mill, dry goods | werking | om | work

+ ete. atore, farm, eK. on owe April during
account. b. | year
1910. 1909.

18 | 20 ai | 2

single

|

Numberof sears of
dumb.

eyes).

Nam

Nuam- ber
Place of birth of Father of Place of birth of
‘ve-sfl oat Place of birth of this Persoa. this person, thle perse

| ing.

Owned tree or

Wheth-
e| ether able to

read.
write.
echedule.

the Unton or Confed-

ton to the Volt
| erate Army or Navy.

| ed Slates.

-
”
en
—
)

rhe ember 1,
v.
mortgaged.

any tUme eloce
iv

der of tisttatlon,

iu order of vine
or divorced.
ized or alien.

lag house In or
Whether @ survivor of

Street, avenn
road. ete. =
Tlouse namber itn
cities or towas),
Namber of dwell
Number of family
Color or race.
Age at last birth-
day
present marriage,
| Year of Immiara-
Whether natural-
Aitended Sebool
Farm or boas.
Nember of farm
Whether blind

Whether
@ | warrled, widowed

il 12 18 14

2 . é
| Lear Llenr. a Cua « Se Best Tit anton Sol Gy ng. bf Fas a ae Bical Le -

EPR =

|
|

|

8 | Whether able to
% | Owned e: cented.

if
o
~
°

¥ # Whether deaf and

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ea
3
iL) g
£

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le

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SSNSSSSNENES

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