| Schedule | Surnames and Other Names | O,V,S,P, or L | M or F | Birth | S,M,W, or D | Personal | See Instructions |
| 105/1 | Cooper Charles E | Male | 14 Dec 1876 | Married | Life Insurance Agent Retired | ||
| 105/2 | Cooper Annie B | Female | 15 Aug 1878 | Married | Unpaid Domestic Duties |
Source: findmypast - 1939 Register RG101/1619C/013/10