1890 Census Form printable pdf download

1890 U.S. Census

Township/Community:

County:

State:

Enumerator Name:

District No.

Date:

Number of dwelling

Number of

Number of this

Number of

house in the order of

families in the

persons in the

family in order

persons in

visitation

dwelling house

of visitation

this family

Individuals

Inquiries

Christian name in full, and initial of

middle name

Surname

Soldier, sailor, or marine during the

Civil War (U.S.A. or C.S.A.), or the

widow of such a person?

Relationship to the head of the family

White, Black, Mulatto, Quadroon,

Octoroon, Chinese, Japanese, or

Indian

Sex

Age

Single, married, widowed, or

divorced

Married within the last year?

Mother of how many children?

No. of those children living?

Place of birth

Father’s place of birth

Mother’s place of birth

Years living in the U.S.

Naturalized citizen?

Have naturalization papers been

taken out?

Profession, trade, or occupation

No. of mos. unemployed in last year

No. of mos. attended school last year

Can person read?

Can person write?

English speaker? If not, native

language?

Acute chronic disease? Name of

disease and length of time

Defective of mind, sight, hearing, or

speech? Crippled, maimed, or

deformed? Name?

Prisoner, convict, homeless child, or

pauper?

Questionnaire for each Family/Farm Visited

Was the family home hired, or was it owned by the head or by a member of the family?

If owned by a member of the family, was the home free from mortgage incumbrance?

If the head of the family was a farmer, was the farm hired or was it owned by him/member of his family?

If owned by the head or member of the family, was the farm free from mortgage incumbrance?

If home was owned and mortgaged by the head/member of family, what was the P.O. address of owner?

1890 Census Form

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