| Schedule | Surnames and Other Names | O,V,S,P, or L | M or F | Birth | S,M,W, or D | Personal | See Instructions |
| 145/1 | Stephens, Henry L | Male | 8 Sep 1875 | Married | Metal Polisher | ||
| 145/2 | Stephens, May | Female | 1 May 1885 | Married | Unpaid Domestic Duties | ||
| 145/3 | Stephens, Dorothy M. | Female | 15 Mar 1930 | Single | At School |
Source: findmypast - 1939 Register RG101/0607F/009/34