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  District:                         County:                        State:    
  Date: 1830                       Ass't Marshall:                           
      Line No:                 (printed)Page No:                             
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     Lastname:                             Firstname:                        
                                                                             
              Free White Persons, Including Heads of Families                
                                                                             
                  Ŀ                   
           Males                                               
                                     
                                                                             
                                                                             
                  Ŀ                   
          Females                                              
                                     
                                                                             
                                                                             
                                                                             
               Slaves                           Free Colored Persons         
      Males              Females              Males              Females     
ĿĿ ĿĿ
                                                 
 ٺ
                                                                             
                                                                             
                                                                             
    Total Persons in Household: [  ]                                         
                                                                             
  White Persons included in the foregoing:                                   
     Who are Deaf and Dumb under fourteen years of age [  ]                  
     Who are Deaf and Dumb of the age of fourteen and under twenty-five [  ] 
     Who are Deaf and Dumb, of twenty-five and upwards [  ]                  
     Who are Blind [  ]                                                      
     Aliens - Foreigners not naturalized [  ]                                
                                                                             
  Slaves and Colored Persons, included in foregoing:                         
     Who are Deaf and Dumb, under fourteen years of age [  ]                 
     Who are Deaf and Dumb, of the age of fourteen and under twenty-five [  ]
     Who are Deaf and Dumb, of twenty-five and upwards [  ]                  
     Who are Blind [  ]                                                      
                                                                             
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Neighbors:                                                                   
                                                                             
Notes:                                                                       
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                              Field Descriptions
                      Whites                        Free Colored and Slaves
           Under  5            50 & Under 60                 Under 10
       5 & Under 10            60 & Under 70            10 & Under 24
      10 & Under 15            70 & Under 80            24 & Under 36
      15 & Under 20            80 & Under 90            36 & Under 55
      20 & Under 30            90 & Under 100           55 & Under 100
      30 & Under 40           100 & Upwards            100 & Upwards
      40 & Under 50
