HEADER:

a. State
b. County
c. Incorporated Place or Township
d. E.D.(enumeration district) Number
e. Hotel, large rooming house, institution, military installation, etc. (name, type, line numbers of residents)
-- Line Number
1. Name of street, avenue or road

For Head of Household:

2. House (and apartment) number
3. Serial number of dwelling unit
4. Is this house on a farm (or ranch)?
5. If no in item 4: Is this house on a place of three or more acres?
6. Agriculture Questionnaire Number

For All Persons:

7. Name (last name first):
· What is the name of the head of household?
· What are the names of all other persons who live here?
· List in this order:
- The head
- His wife
- Unmarried sons and daughters and their families (in order of age)
- Married sons and daughters and their families
- Other relatives
- Other persons, such as lodgers, roomers, maids or hired hands who live in, and their relatives

8. Relationship:
Enter relationship of person to head of household, as
Head
Wife
Daughter
Grandson
Mother-in-law
Lodger
Lodger's wife
Maid
Hired hand
Patient, etc.

9. Race:
White (W)
Negro (Neg)
American Indian (Ind)
Japanese (Jap)
Chinese (Chi)
Filipino (Fil)
Other race -- spell out

10. Sex
Male (M)
Female (F)

11. How old was he on his last birthday? (If under one year of age, enter month of birth as April, May, Dec., etc.)

12. Is he now married, widowed, divorced, separated, or never married? (Mar, Wd, D, Sep, Nev)

13. What State (or foreign country) was he born in?

· If born outside Continental United States, enter name of Territory, possession, or foreign country
· Distinguish Canada-French from Canada-other

14. If foreign born:
Is he naturalized? (Yes, No, or AP for born abroad of American parents)

For Persons 14 Years of Age and Over:

15. What was this person doing most of last week: working, keeping house, or something else? (Wk, H, Ot, or U for unable to work)

16. If H or Ot in Item 15:
Did this person do any work at all last week, not counting work around the house? (Include work for pay, in own business, profession, on farm, or unpaid family work) (Yes or No)

17. If No in Item 16:
Was this person looking for work? (See special cases below) (Yes or No)

18. If No in Item 17:
Even though he didn't work last week, does he have a job or business? (Yes or No)

19. If Wk in Item 15 or Yes in Item 14:
How many hours did he work last week? (Include unpaid work on family farm or business) (Number of hours)

20. · If employed (Wk in Item 15, or Yes in Item 16 or Item 18), describe job or business held last week.
· If looking for work (Yes in Item 17), describe last job or business.
· For all other persons, leave blank.

20a. Occupation:
What kind of work was he doing?

20b. Industry:
What kind of business or industry was he working in?

20c. Class of Worker:
P Private employer
G Government
O Own business
NP Without Pay on family farm or business

Occupation/Industry/Class of worker examples:
- Nails heels on shoes/Shoe factory/P
- Chemistry Professor/State Univ./G
- Farmer/Farm/O
- Farm helper/Farm/NP
- Armed forces/ /
- Never worked/ /

THE QUESTIONS BELOW ARE FOR PERSONS LISTED ON SAMPLE LINES:

21. Was he living in this same house a year ago? (check box for Yes or No)

If No in Item 21:

22. Was he living on a farm a year ago? (check box for Yes or No)

23. Was he living in this same county a year ago? (check box for Yes or No)

If No in Item 23:

What county and State was he living in a year ago?

24a. County (If county unknown, enter name of place or nearest place)

24b. State or foreign country

25. What country were his father and mother born in? (Enter US or name of Territory, possession, or foreign country)
Father:
Mother:

26. What is the highest grade of school that he has attended? (Enter one grade --see codes below)

27. Did he finish this grade?
(check box for Yes or No)

28. Has he attended school at any time since February 1st?
· For those under 20 years of age check Yes or No.
· For those 20 years of age and over, check 20 or over.

For Persons 14 Years of Age and Over:

29. If looking for work (Yes in Item 17):
How many weeks has he been looking for work? (Number of weeks)

30. Last year, in how many weeks did this person do any work at all, not counting work around the house? (Number of weeks in 1949 or None)

31. Income received by this person in 1949:

31a. Last year (1949), how much money did he earn working as an employee for wages or salary?
(Enter amount before deductions for taxes, etc. or None)

31b. Last year, how much money did he earn working in his own business, professional practice, or farm? (Enter net income or None)

31c. Last year, how much money did he receive from interest, dividends, veteran's allowances, pensions, rents, or other income (aside from earnings)? ($ or None)

32. If this person is a family head (see definition below) -- Income received by his relatives in this household:

32a. Last year (1949), how much money did hs relatives in this household earn working for wages or salary? (Amount before deductions for taxes, etc. or None)

32b. Last year, how much money did his relatives in this household earn in own business, professional practice, or farm? (Net income or None)

32c. Last year, how much money did his relatives in this household receive from interest, dividends, veteran's allowances, pensions, rents, or other income (aside from earnings):

($ or None)

33. If Male (Ask each question):

Did he ever serve in the U.S. Armed Forces during:

33a. World War II

33b. World War I

33c. Any other time, including present service

QUESTIONS FOR THE PERSON WHOSE NAME FELL ON THE LAST SAMPLE LINE:

34. To enumerator: If worked last year (1 or more weeks in Item 30):

Is there any entry in Items 20a, 20b, or 20c?

If Yes: Skip to Item 36
If No: Make entries in Items 35a, 35b, and 35c.

35a. What kind of work did this person do in his last job?

35b. What kind of business or industry did he work in?

35c. Class of worker (P, G, O, or NP, as in Item 20c).

36. If ever married (Mar, Wd, D, or Sep in Item 12):
Has this person been married more than once? (check box for Yes or No)

37. If Mar: How many years since this person was (last) married?
If Wd: How many hears since this person was widowed?
If D: How many years since this person was divorced?
If Sep: How many years since this person was separated?
(Enter number of years or check Less than 1 year.)

38. If female and ever married (Mar, Wd, D, or Sep in Item 12):
How many children has she ever borne, not counting stillbirths? (Enter number of children or None.)