Houses
- Number -- of house or building. This corresponds to house number in Form A.
 
 - Whether Built or Building
 - Type -- State whether Private Dwelling (PD), Public Building, School, Manufactory, Hotel, Public House, Lodging-house, or Shop, & c.
 - Number of out-offices and Farm-steadings as returned on form B.2.
 - Is house inhabited? Yes or No, as the case may be.
Particulars of inhabited houses
 - Walls --   If walls are of stone, brick, or concrete, enter the figure 1 in this column; if they are of mud, wood, or other perishable material; enter the figure 0.
 - Roof --   If roof is of Slate, Iron, or Tiles, enter the figure 1 in this column; if it is of Thatch, Wood, or other perishable
material, enter the figure 0.
 - Rooms --   Enter in this column:
- For each House with 1 Room only --   the figure 1
 - For Houses with 2, 3, or 4 rooms --    2
 - 5 or 6 rooms --    3
 - 7, 8, or 9 rooms --    4
 - 10, 11, or 12 rooms --     5
 - 13 or more rooms --    6
  
 - Windows in Front --  State in this column the exact Number of Windows in Front of House
 - Total the figures you have entered in columns 6, 7, 8, & 9 and enter the Total for each house in this column.
 - Class of House --   When Total in Col. 10 is: --
| 1 or 2 |                         
enter "4th" |  
| 3, 4, or 5 | enter "3rd" |  
| 6, 7, 8, 9, 10, or 11 | enter "2nd" |  
| 12 or over | enter "1st" |  
  
Families, &c.
 - No. of distinct Families in each House.
 - Name of the Head of each family living in the House.
 - No. of Rooms occupied by each Family.
 - Total Number of Persons in each Family.
 - Date on which Form A was collected
 - Number of Persons in each Family who were sick on 2nd April 1911.
 - Name of the Landholder (if any) on whose Holding the House is situated,   whether that name appears in Column B or not.
 - No. on Form M.1 if House is on the Holding of a Landholder.
  
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