| Name and Surname | Charles Boyd |
| Relation to Head of Family | H[ea]d of Family |
| Religious Profession | Church of Ireland |
| Education | Read & Write |
| Age | 32 |
| Sex | M |
| Rank, Profession or Occupation | Coachman Domestic Servant |
| Particulars as to Marriage | Not Married |
| Where Born | Co Mayo |
| Irish Language | |
| Deaf, Dumb, etc. |
| County | Roscommon |
| Parliamentary Division | South Roscommon |
| Poor Law Union | Castlerea |
| District Electoral Division | Ballinlough |
| Townland | Cashlieve |
| Barony | Castlerea |
| Parish | Killineagh? |
| No of House | 8 | |
| Whether Built or Building | Built | |
| Private Dwelling etc | Private Building | |
| Number of Out-Offices and Farmsteadings as returned on Form B.2 | ||
| Is House Inhabited? | Yes | |
| Particulars of Inhabited Houses | Walls | Son, Brick or Concrete |
| Roof | Slate, Iron, or Tiles | |
| Rooms | 2, 3, or 4 rooms | |
| Windows in Front | 3 | |
| Total | 7 | |
| Class of House | 2nd | |
| Families | No of distinct families | 1 |
| Name of the Head of each Family | Charles Boyd | |
| Number of Rooms occupied | 1 | |
| Number of Persons in each Family | 1 | |
| Date on which Forma A was collected | April 19th. | |
| Number of Persons who were sick on 2nd April 1911 | ||
| Name of the Landholder | E W Landford Wills | |
| No. of Form M.1 | 2 | |
Source: National Archives of Ireland