| Schedule | Surnames and Other Names | O,V,S,P, or L | M or F | Birth | S,M,W, or D | Personal | See Instructions |
| 276/1 | Clark Henry | Male | 3 Jul 1892 | Married | Loco Engine Driver | ||
| 276/2 | Clark Mary E. | Female | 30 Oct 1892 | Unpaid House Duties | ARP Warden N... | ||
| 276/3 | Clark percy George | Male | 13 Dec 1916 | Single | Sand Blaster Machine Operator |
Source: findmypast - 1939 Register RG101/0969H/021/1