5. Name and address of person, if any, accompanying you--None

6. Description of room, house, surroundings, etc.--A frame house

(rented), bare floors, no window shades; a bed and some boxes and three

straight chairs. In an adjoining room were another bed, heating stove,

two trunks, one straight chair, one rocking chair. A third room, the

kitchen, contained cookstove and table and chairs.