| Surname | First Name | Year of Birth | Male or Female | Head of Household | Married, Single, Widow, Widower | Occupation | State of Birth |
| Coffman | Reamer L. | 1879 | M | Head | M | Oh | |
| Olive | 1878 | F | Wife | M | Ill | ||
| Roy | M | Son | S | " | |||
| Grace | 1898 | F | Daughter | S | " | ||
| Coffman | Adam E. | 1853 | M | Head | M | Germany | |
| Mary Jane | 1842 | F | Wife | M | Oh | ||
| Genetta | 1874 | F | Daughter | S | Oh | ||