| Province | Ontario |
| District No. | 99 |
| S. District No. | ??? ??? |
| Enumeration District | 89 in Casey and Harris |
| Page | G? |
| Nominal return of living persons by | Hugh Keats |
| Numbered in the Order of Visitation | Dwelling House | 100 | |
| Family, Household or Institution | 100 | ||
| Residence and Personal Description | Name of each person in family, household or institution | Chapman Charles | Agnes [sic] |
| Place of habitation | Casey | Casey | |
| Sex | M | F | |
| Relationship to head of family or household | Head | Wife | |
| Single, married, widowed, divorced or legally separated | M | M | |
| Month of birth | April | December | |
| Year of birth | 1834 | 1833 | |
| Age at last birthday | 75 | 77 | |
| Citizenship, Nationality and Religion | Country or place of birth | England | ? New Brunswick |
| Year of immigration to Canada, if an immigrant | 1909? | ||
| Year of naturalization, if formerly an alien | |||
| Racial or tribal origin | English | Canadian? | |
| Nationality | English | English | |
| Religion | Methodist | Methodist | |
| Profession, Occupation, Trade or Means of Living | Chief occupation or trade | Post Master? | |
| Employment other than at chief occupation or trade, if any | ??? | ??? | |
| Employer | ??? | ||
| Employee | No? | ||
| Working on own account | ??? | ||
| Wage-Earners | State where person is employed, as "on farm", "in woolen mill", "at foundry shop", "in drug store", etc. | on Farm? | |
| Weeks employed in 1910 at chief occupation or trade | 52 | ||
| Weeks employed in 1910 at other than chief occupation or trade, if any | |||
| Hours of working time per week at chief occupation | ??? | ||
| Hours of working time per week at other occupation, if any | |||
| Total earning in 1910 from chief occupation or trade | 200? | ||
| Total earning in 1910 from other than chief occupation or trade, if any | |||
| Rate of earnings per hour when employed by the hour - Cents | |||
| Insurance Held at Date | Upon life | ||
| Against accident or sickness | |||
| Cost of insurance in coming year | |||
| Education and Language of Each Person Five Years of Age and Over | Months at school in 1910 | ||
| Can read | yes | yes | |
| Can write | yes | yes | |
| Language commonly spoken | E | E | |
| Cost of education in 1911 for persons over 16 years of age at College, Convent or University | |||
| Infirmities (Specify age when infirmity appeared) | Blind | ||
| Deaf and dumb | |||
| Crazy or lunatic | |||
| Idiotic or silly |
Source: Year: 1911; Census Place: 30 - Casey, Harris, Nipissing, Ontario;
Page: 9; Family No: 100
Source: Ancestry.com. 1911 Census of Canada