| Schedule | Surnames and Other Names | O,V,S,P, or L | M or F | Birth | S,M,W, or D | Personal | See Instructions |
| 1/1 | Smith Edward E | Male | 5 May 1900 | Married | Locomotive Driver | ||
| 1/2 | Smith Elsie M | Female | 18 Feb 1902 | Married | Unpaid domestic duties | ||
| 1/3 | Smith Edward C | Male | 29 Aug 1924 | Single | At school | ||
| 1/4 | Ashwell Ada A | Female | 16 Sep 1912 | Single | Clerk (Invoice) |
Source: findmypast - 1939 Register RG101/0865E/001/1