| Name | Birth Year | Birth Place |
| Annie Forman | 1907 | Leeds, Yorkshire, England |
| Benny Forman | 1916 | Leeds, Yorkshire, England |
| Harry Forman | 1912 | Leeds, Yorkshire, England |
| Hetty Forman | 1880 | Russia |
| Isaac Forman | 1880 | Russia |
| Jacob Forman | 1909 | Leeds, Yorkshire, England |
| Nathan Forman | 1918 | Leeds, Yorkshire, England |
| Pearl Forman | 1914 | Leeds, Yorkshire, England |
| Tilly Forman | 1911 | Leeds, Yorkshire, England |
| Sarah Idney | 1894 | Edinburgh, Midlothian, Scotland |
| Leah Thomas | 1897 | Leeds, Yorkshire, England |
| Address | 42 Samuel Street |
| Parish | Leeds |
| Registration District | Leeds |
| County | Yorkshire (West Riding) |
Source: findmypast - 1921 Census