| Name of Street. | Postal[A] No. or Nos. of houses. | No. of rooms in each house. | Annual Rent[B] (including rates) of each house. | Annual Rates on each house. | P.L. Valuation of each house. | |||||||||||||||
| July, 1914. | Mar., 1922. | June, 1922. | July, 1914. | Mar., 1922. | June, 1922. | July, 1914. | Mar., 1922. | June, 1922. | ||||||||||||
| £ | s. | £ | s. | £ | s. | £ | s. | £ | s. | £ | s. | £ | s. | £ | s. | £ | s. | |||
| [A. Owned by the Local Authority.] | ||||||||||||||||||||
| [B. It is the Annual rent that should be entered; accordingly weekly, monthly or quarterly rents at the above dates should be multiplied by 52, 12, or 4 respectively, and the result entered.] | ||||||||||||||||||||
II.—PART ONLY OF HOUSE OCCUPIED BY FAMILY.
II.—The houses or tenements should be in as many different districts as possible and the particulars should be representative of wage-earning class accommodation in those districts. Actual rents are to be given: different rents are not to be averaged.
| Name of Street. | Postal No. of house. | Number[A] of rooms occupied by each famaily selected. | Amount of Rent paid per week for the rooms. | |||||
| July, 1914. | Mar., 1922. | June, 1922. | ||||||
| £ | s. | £ | s. | £ | s. | |||
| [A: The numbers required are to represent different types of wage-earning class accommodation and, therefore, families should be selected occupying different numbers of rooms so as to properly represent local conditions.] | ||||||||
| Date ___________________ 1922. | Signature _____________________________ | |||||||
HOUSEHOLD BUDGET.
Particulars for all persons in a household at _________ Co. __________ during the seven days ended ___ June, 1922.
(Note.—Particulars for each person should be given, one line being devoted to each).
| Description (e.g., husband, wife, father, son, niece, servant, lodger, &c.). | Sex (M) Male (F) Female | Age. | Occupation.[A] | Earnings for the seven days.[B] |
| s. d. | ||||
| (1) | ||||
| (2) | ||||
| (3) | ||||
| (4) | ||||
| (5) | ||||
| (6) | ||||
| (7) | ||||
| (8) | ||||
| (9) | ||||
| (10) | ||||
| [1. e.g.,, "Carpenter," "dock labourer," "domestic duties," "at school," &c.] | Total earnings (A) | |||
| [2. If there is a servant, her wages should not be included here. | Other receipts[E] | |||
| Total income (B) | ||||
| (E) Receipts of old age or other pensions should be included here and not in the column for "earnings" above. | ||||
| Please state on the following lines particulars of pensions or other receipts:— | ||||
| Observations with regard to particulars on this page. | SUMMARY. | |||
| Number of Persons | ||||
| No. | ||||
| Who earned cash (A) | ||||
| Who did not earn cash (A) | ||||
| Total number of persons in the household | ||||
| Total income (B) for the seven days | s. d. | |||
| Number of Persons | ||||
| No. | ||||
| Under 4 years | ||||
| 4 years to 13 (inclusive) | ||||
| 14 years and over | ||||
| Total number of persons in the household | ||||