The following questionnaire was addressed, via the High Bailiffs, to all clergymen in the Island.
High Bailiff Robert Moore of Peel aggregated the various returns made to him (which covered the West of the Island) though he commented in a letter that many of the clergy were either unable or unwilling to answer the questions as posed.
I am directed by His Excellency the Lieutenant-Governor to furnish him with information on the following Subjects, I therefore transmit the several Questions at foot hereof which are addressed to you for the purpose of better enabling me to make the required Returns to His Excellency and I shall feel obliged if you will previous to the 1st of May next supply me with the required information so far as you are enabled so to do.
I am Sir, ...
1. The Names and Addresses of those Persons who within your knowledge are entirely dependent on Charity for support, distinguishing the sexes and ages as nearly as can be ascertained.
2. Whether any, and which of the said Persons are so dependent on Charity from age or infirmity, or from other causes, that preclude from earning their own livelihood.
3. The Names and Addresses of those Persons who are partly dependent on Charity for relief.
4. Whether any of the last mentioned class and which of them are unable from age or infirmity to do more than contribute by there [sic] work towards earning their own livelihood.
5. The Names and Addresses of those persons dependent on Charity capable of working, but who from idleness and dissipation refuse to do so.
6. Whether the number of persons who come under the above classifications is on the increase
7. Whether those who require assistance are sufficiently provided with Food, Clothing and Shelter
8. The system of Medical Attendance on the Poor who are unable to pay for advice or medicine.
9. Whether you are acquainted of your own knowledge or have heard from others of Persons, dying from absolute want, arising either from starvation, exposure, or an absence of that attention which in respect of persons of old age or infirmity may be classified as dying from neglect, and if so state the instance.
10. The Funds that are available under your control and that may be depended on for distribution amongst the Poor; whether arising from Bequests, Interest on Monies invested, Church Collections, or well-ascertained. Annual Subscriptions.
As witness my Name this ....
Note. - In filling-up return the above it will be very desirable if the Persons receiving relief were classified, distinguishing those who are natives of the Island from the others whose place of birth may also be ascertained.
N.B. - All the questions hare reference to the year ending 31st December 1868.