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Street, avenue, road, etc.
House number in cities or towns.
1) Number of dwelling house in order of visitation.
2) Number of family in order of visitation.

3) NAME of each person whose place of abode on April 15, 1910, was in this family.  Enter the surname first, then the given 
name and middle initial, if any.  Include every person living on April 15, 1910.  Omit children born since April 15, 1910.

4) Relationship of this person to the head of the family.

5) Sex.
6) Color or race.
7) Age at last birthday.
8) Whether single, married, widowed, or divorced.
9) Number of years of present marriage.
Mother of how many children.
  10) Number born.
  11) Number now living.

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.
  12) Place of birth of this person.
  13) Place of birth of Father of this person.
  14) Place of birth of Mother of this person.

15) Year of immigration to the United States.
16) Whether naturalized or alien.

17) Whether able to speak English; or, if not, give language spoken.

18) Trade or profession of, or particular kind of work done by this person, as spinner, salesman, laborer, etc.
19) General nature of business, industry, or establishment in which this person works, as cotton mill, dry goods store, farm, etc.
20) Whether an employer, employee, or working on own account.
If an employee
  21) Whether out of work on April 15, 1910.
  22) Number of weeks out of work during year 1909.

23) Whether able to read.
24) Whether able to write.
25) Attended school any time since September 1, 1909.

26) Owned or rented.
27) Owned free or mortgaged.
28) Farm or house.
29) Number of farm schedule.

30) Whether a survivor of the Union or Confederate Army or Navy.
31) Whether blind (both eyes).
32) Whether deaf and dumb.
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Last Modified 01.01.2016