| Schedule | Surnames and Other Names | O,V,S,P, or L | M or F | Birth | S,M,W, or D | Personal | See Instructions |
| 109/1 | Andrewartha John | Male | 21 Jan 1912 | Married | Taxi-cab Washer | ||
| 109/2 | Andrewartha Doris M | Female | 1 Jun 1913 | Married | Mantle Machinist |
Source: findmypast - 1939 Register RG101/0350C/007/20