| 1. House Number |
10. # of children now living |
| 2. Name of person whose place of abode on January 1, 1920 |
11. Place of Birth |
| 3. Relationship to head-of-household |
12. Father's Place of Birth |
| 4. Sex |
13. Mother's Place of Birth |
| 5. Color or Race |
14. Able to speak English |
| 6. Age |
15. Trade or Profession |
| 7. Marital status |
16. Nature of trade or Profession |
| 8. # of years of present marriage |
17. |
| 9. # of Children born |
18. |
