Blank Form 1904 [PDF 322.92KB]

C.L.9.
Information for the use of the Labour Department, Board of Trade, 43, Parliament Street, London, S.W.
EXPENDITURE OF WORKMEN’S FAMILIES
STATEMENT SHOWING THE EXPENDITURE ON FOOD AND RENT IN THE WEEK BY
A WORKMAN, HIS WIFE AND CHILDREN.
[Individual returns are regarded as confidential and will not be published separately. No names
need be given.]
1. Locality _________________________________________________________________
2. Number and Ages of Children
3. State whether any members of the family
buy meals at eating houses, and if so,
what was the total weekly cost of such
meals
__________________
__________________
__________________
4. State occupation of father and average
weekly earnings of the family:Occupation of father
__________________
Average weekly earnings of father __________________
Average weekly amount of additional
family income
__________________
5. State the amount paid per week for House
Rent, and Number of rooms occupied:Rent
__________________
Number of Rooms
__________________
N.B. If the father owns the house, please state the fact
P.T.O.
C.L.9.
DETAILS OF FAMILY EXPENDITURE ON FOOD.
Articles of Food.
Bread
Flour
Biscuits and Cake
Meat bought by weight: Beef
Mutton
Pork
Veal
Bacon
Sausages
Other Meat : Sheeps’ Head, tripe,
Heart, liver and pig’s
Fry
Tinned meats
Rabbits
Fish
Lard, suet, dripping
Eggs
Milk
Condensed Milk
Cheese
Butter
Margarine
Cost
per
Week.
s. d.
Quantity
consumed
per Week.
Articles of Food.
Potatoes
Vegetables (other than
Potatoes)
Fruit (fresh)
Currant
Raisins
Rice
Tapioca and Sago
Oatmeal
Tea
Coffee
Cocoa
Sugar
Jam, Marmalade
Treacle and Syrup
Pickles
Condiments (Salt, Pepper,
Mustard and Vinegar)
Unspecified articles of food
and drink (excluding
Intoxicating Drinks and
Tobacco)
Remarks.
Cost
per
Week.
s. d.
Quantity
consumed
per Week.