| Schedule | Surnames and Other Names | O,V,S,P, or L | M or F | Birth | S,M,W, or D | Personal | See Instructions |
| 17/1 | Stephenson Charles Henry | Male | 19 Mar 1892 | Married | Head Carpet Salesman (Co-op Stores) | ||
| 17/2 | Stephenson Mary | Female | 5 Apr 1892 | Married | Unpaid domestic duties |
Source: findmypast - 1939 Register RG101/3408B/002/37