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FORM
A. No.
on Form
RETURN of the MEMBERS of this FAMILY and their VISITORS, BOARDERS,
SERVANTS, &c., who slept or abode in this House
on
the night of SUNDAY, the 2nd of APRIL, 1911.
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Number
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NAME
and SURNAME
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Relation
to Head of Family
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Religious
Profession
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EDUCATION
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AGE
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SEX
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RANK,
PROFESSION OR OCCUPATION
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MARRIAGE
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Number
of years the marriage has lasted |
Total
children born alive to this marriage |
Children
still living |
WHERE
BORN
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I hereby certify, as required by the Act 10 Edw. VII., and 1 Geo. V., cap.11,,
that the
I believe the foregoing to be a true Return
Foregoing Return is correct according to the best of my knowledge and
belief.
John Condon
(Signature
of Head of family)
P.
Kenny, Constable
(Signature of Enumerator)
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