| Schedule | Surnames and Other Names | O,V,S,P, or L | M or F | Birth | S,M,W, or D | Personal | See Instructions |
| 203/1 | Burton Samuel | Male | 20 Apr 1888 | Widower | Lathe Hand | ||
| 203/2 | Burton Samuel (Jnr.) | Male | 9 Nov 1907 | Single | Driller Heavy W |
Source: findmypast - 1939 Register RG101/3447G/018/35