| Schedule | Surnames and Other Names | O,V,S,P, or L | M or F | Birth | S,M,W, or D | Personal | See Instructions |
| 233/1 | Jackson, Clem H. | Male | 18 Jul 1881 | Married | Iron Moulder in Armaments | ||
| 233/2 | Lily Jackson | Female | 22 Jun 1881 | Married | Unpaid DD |
Source: findmypast - 1939 Register RG101/3569G/017/25