| Street, avenue, road, etc. | House number or farm, etc. | No. of house in order of visitation | No. of family in order of visitation | Name of each person whose place of abode on January 1, 1920 was in this family. Enter surname first, then given and middle initial if any. Omit Children born since January 1, 1920. | Relationship of each person to the head of this family - whether wife, son, daughter, servant, boarder, or other. | Home owned or rented. | If owned, free or mortgaged. | Sex. | Color or race. | Age at last birthday. | Whether single, married, widowed, or divorced. | Year of immigration to the U.S. | Whether naturalized or alien. | If naturalized, give the year. | Attended school any time since September 1, 1919. | Whether able to read. | Whether able to write. | Place of birth - this person. | Mother tongue - this person. | Place of birth - Father of this person. | Mother tongue - Father of this person. | Place of birth - Mother of this person. | Mother tongue - Mother of this person. | Whether able to speak English. | Trade, profession, or particular kind of work done, as spinner, salesman, laborer, etc. | Industry, business, or establishment in wihich at work, as cotton mill, dry goods store, farm, etc. | Employer, salary or wage worker, or working on own account. | Number of farm schedule. |
