| No. in Admissions Register: | 505 |
| Age: | 15 |
| Whence received: | Stafford County Prison |
| Description: | |
| Complexion: | Fresh |
| Hair colour: | Brown |
| Eyes colour: | Grey |
| Visage: | - |
| Particular marks: | - |
| State of health: | Good |
| Able-bodied? | Yes |
| Date of admission and term: | 1 April 1874 5 years |
| Late residence: | Hanley |
| Parish he belongs to: | Tunstall |
| Customary work and mode of life: | Potting |
| Whether illegitimate: | - |
| State of education: | |
| Reads: | Imperfectly |
| Writes: | Imperfectly |
| Offence: | Stealing a coat |
| Circumstances which may have led to it: | - |
| Date of sentence, by who and court: | 1 January 1874, Hanley Petty Sessions, E T Bodley and J B Boothroy |
| Where imprisoned: | Stafford |
| Sentence: | 3 months prison (hard labour), 5 years at Saltley |
| Previous committals: | |
| Number: | None |
| Length: | - |
| For what: | - |
| Father's name: | - |
| Occupation: | - |
| Mother's name: | Sarah Gardner |
| Occupation: | - |
| Parents dead? | Father |
| Survivor married again? | No |
| Parents' treatment of child: | Good |
| Character of parents | Honest and sober, health good |
| Parents' wages: | None |
| Amount parents agree to pay: | None |
| Parents address: | Hanley |
| Superintendent of police (to collect payments): | - |
| Person making this return: | - |
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