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Census of Population of Ireland, 1971

Census Day: Sunday 18 April, 1971

Central Statistics Office, Dublin

Form A strictly confidential. To be filled in by the official enumerator:

A.
_____ County or Co. Borough
_____ D.E.D. or Ward
_____ Townland
_____ Town
_____ Street, etc., and number of house

B.
[] 1 Private household
[] 2 Non-private household

Name (if any) _____

C.
Number of persons in household:
Persons_____

____ Males
____ Females

D.
Schedule number_____

1. Name and surname_____

Particulars of the head of the household should be inserted on the first line.

2. Sex _____

If male write "M", if female write "F".

3. Relationship to head of household_____

Write "Head", "Wife", "Son", "Daughter", "Visitor", "Inmate", "Employee", etc. as appropriate.

4. Usual residence______

If the person usually lives at this address, write "Here". If not, state the usual address in full.

5. Usual residence one year ago______

If the person's usual address one year ago was the same as that given in column 4, write "Same". If not, write in full the usual address at that time. For children now under one year old write "Under 1".

6. Place of birth____

County, if born in Ireland. Country, if born elsewhere.

7. Date of birth

Day___
Month___
Year___

8. Marriage ____

If 14 years of age or over, write "Single", "Married" or "Widowed", as appropriate. If under 14 years of age, write "Child"

[Questions 9 and 10 must be answered by married women only]

9. Month and year of present marriage

Month___
Year___

10. Number of children born alive to present marriage___

If none, write "None".

11. Religion___

State particular denomination.

12. Ability to speak the Irish language____

Write "Irish only", "Irish and English", "Read but cannot speak Irish", or leave blank as appropriate.

13. Transport to work or school

At (a), state the usual means of transport to work or school. At (b), state to the nearest mile, the distance from residence to work or school. If the person walks to work or school, or works at home, write "None" at (a).

(a)___
(b)___

[Questions 14-18 are be completed for each person aged 14 years or older]

14. Principal occupation ____

If usually working for payment or profit, even if at present out of work, state here the usual principal occupation, giving a full description. For other persons, write as appropriate: "Home duties", "At school" (primary, secondary or vocational), "Student" (medicine, law etc.), "Not yet at work", etc.

15. Employment status_____

If usually working for payment or profit, state whether "Employee", "Assisting relative", "Self employed", "Employs others" or "Self employed, without employees". If at present out of work, write "Out of work".

16. Employer and employer's business______

If an employee, state the name of the employer (person, firm, company or public body), address of place of work and nature of business carried on by employer.
If self employed, state nature of business in which engaged
If a farmer, state the area and total ratable valuation of the farm on which working
If a farm worker, state the area of the farm on which working
If out of work, state the name, address and nature of the business of last employer.

17. Full-time education received:

If the person attended the following types of school or college full-time, state the number of years in each case. If the person did not attend, write "None".

State age at which full-time education ended____
Secondary: ___ years

Vocational, technical, or commercial: ___ years

University or higher technical: ____ years

18. Scientific or technological qualifications

If the person has such qualifications, state at (a) the qualifications held and at (b) the main subject(s) in which they are held.

(a) ____
(b) ____

[The following questions should be answered in respect of each private household and of the house, flat or rooms occupied by that household. These questions need not be answered in respect of private households living in caravans or other mobile dwellings.]

19. Agricultural holdings _____

State the area and ratable valuation of all agricultural holdings (if any) in the state, of which persons usually resident in the household are the rated occupiers. Land held under the eleven months system, in conacre, or in commonage should not be included.

State the area and ratable valuation of all agricultural holdings (if any) in the state, of which persons usually resident in the household are the rated occupiers. Land held under the eleven months system or in conacre or in commonage should not be included.

Area in statute acres _____

Valuation (land and buildings): ______ pounds

20. Nature of occupancy of house, flat or rooms

[] Rented from local authority (corporation, county or urban district council)
[] Rented unfurnished, other than from local authority
[] Rented furnished or part furnished
[] Being acquired from local authority under a purchase or vested cottage scheme
[] Owner occupied (including cases where loan or mortgage repayments are being made)
[] Occupied free of rent (caretaker, company official, etc.)

21. Rent

[Only if the answer in question 20 was 1, 2 or 3]

If the house, flat or rooms are rented, state the rent (inclusive of rates and ground rent) and strike out periods which do not apply.

Pounds _______ (per week, month or year)
Pence _______ (per week, month or year)

If the house, flat or rooms are rented unfurnished other than from a local authority, did the letting commence before 1961?

[] Yes
[] No

22. Year in which house was built

Indicate the period in which the house or other building containing the dwelling was built by inserting X in the appropriate box. The year in which first built is required even if subsequently converted or reconstructed.

[] Before 1860
[] Between 1860 and 1899 inclusive
[] Between 1900 and 1918 inclusive
[] Between 1919 and 1940 inclusive
[] Between 1941 and 1960 inclusive
[] 1961 or after

23. Rooms ____

State the number of rooms occupied by the household (including kitchen but excluding kitchenette, scullery, bathroom, toilet, consulting room, office or shop.

24. Water supply

[] Water tap, inside the building, connected to public main
[] Water tap, outside the building only, connected to public main
[] Water tap, inside the building, connected to private source
[] Water tap, outside the building only, connected to private source
[] No piped water supply

25. Bath or shower:
Has the household the use of a fixed bath or shower?

[] Yes
[] No

If "Yes", is this bath or shower shared with another household?

[] Yes
[] No

26. Sanitary facilities

[] Flush toilet
[] Dry closet
[] Chemical closet
[] No toilet or closet

Is the toilet or closet inside the building?

[] Yes
[] No

Is the toilet or closet shared with another household?

[] Yes
[] No

27. Electricity:
Is an electricity supply laid on to the dwelling?

[] Yes
[] No

28. Motor cars_____

State how many motor cars, taxed as private vehicles, are used exclusively by persons usually resident in the household (Include company cars kept at home). If none, write "None".