@aterects. Date
or Inveatugaiion.

S.D.No.....7. s,s «xELD.No. 7/F-3/

1940

facts, including namesor Mdentity, from

population, re

DEPARTMENT OF COMMERCE—BUREAU OF THE CENSUS

SIXTEENTH CENSUS OF THE UNITED STATES

This Act makes it unlawful for the Bureau to disclose

statistical information concerning the Nation's

Ward of city -_-...--

sate Letcethaxghan/ __ Incorporated place

Township or other

Enumerated by me on

POPULATION SCHEDULE

A,

"ORF alte
erucreedaga! 223 Brock Nos. Institution

division of county

EDUCATION| PLACE OF BIRTH

PERSONAL
DESCRIPTION

LOCATION | HOUSEHOLD DATA

(OM 2080) 4ORGT ‘Tt Tore cout? § | 65

i
[8 3] s] as] a 8

3! 3] 3] 3! s/o] 3] si] e| = fi 2 2)

oreseuanee SECC CIRCE CELE CEL ELLE LLL LL :

eee SRECKER TE CHIESCEEEE PRECEGEKG CK aye
PECUBEN CNG BMERERECE

ney poten ne Baa _LESEE CeSCCOSOEE TT IN ys Ty Tay TN La ail oo
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TTT RTT RTS TS Tat TST a
4 . S

:

does
29 and 30 blank.

—

(a) If be has
if

assigned to public emergency work, or with a job (“TYes” in
ker; or

or 24), enter present occupation, industry, and class of worker.
ustry, and class of wor
worker” in Col. 28, and leave

OCCUPATION, INDUSTRY, AND CLASS OF WORKER

at work,

it, 22,

last occupation, ind
enter “New

For a person seeking work (“‘Yes” in Cal. 83):

a
Col.

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sa quew Laue we

-Uh jo Wore

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ar 9

TT ele Te

SCRCRERBEECEC
inne KR

z NIRS

, not the U.S. Census Bureau.

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for more information about publicly available records like the one shown here.

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ose usual
, 1940, was
year of age. Write “Infant”

if child bas not been given o frst name.

pril 1
1. Persons temporarily absent from household.
Write “Ab” afer aames of such persons.

this household.
2%. Children under 1

BE SURE TO INCLUDE:

of residence on A

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pera 7 ‘reyues

A[qyaeu 30 ‘poumo Fy * emoy jo enreg

AN
SEPEEEE CT

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FOR OFFICE USE ONLY—DO NOT WRITE IN THESE COLUMNS

FOR PERSONS 14 YEARS OLD AND OVER

(qUTQIINS epnfouy you ocr)
@J0q JeA0 Wespijqo jo zequing

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(osy 20 80x) 40070 Wwy) e20uZ
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and at which he
at which he
Enter

usual occupation
this, enter that occu

is unable to

USUAL OCCUPATION, INDUSTRY, AND CLASS OF WORKER
which the person ey vee aa

work. Ifthe

Enter that occupation

TIVE

(OR BA

FOR PERSONS OF ALL AGES

SUPPLEMENTARY
QUESTIONS
For Persons Enumerated on Lines 55 and 6S

MOTHER TONGUE

LANGUA

ce
AY
Ee aa

nish-Americas War,

Col. 41. WAR OR MILITARY SERVICE:
_ Werld War.____.....------

Cols. 30 and 47. CLASS OF WORKER:

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i ul
it ae

i iH
eat
att ‘tie i

Col. 16. CITIZENSHIP OF THE FOREIGN