| No. in Admissions Register: | 369 |
| Date of admission: | 21 December 1867 |
| Whence received: | Birmingham Gaol |
| By whom brought: | - |
| On what terms: | - |
| Friends interested in him: | - |
| Description: | |
| Height: | - |
| Figure: | - |
| Complexion: | Fresh |
| Hair colour: | Brown |
| Eyes colour: | Grey |
| Perfect vision? | Yes |
| State of health: | Good |
| Able-bodied? | Yes |
| Sound intellect? | Yes |
| Use of all limbs? | Yes |
| Had cow or small pox? | Smallpox |
| Particular marks: | Pock pitted; cast in left eye |
| Cutaneous disorder? | No |
| Scrofulous or consumptive? | No |
| Subject to fits? | No |
| Age last birthday: | 11 |
| Illegitimate? | - |
| Birthday: | - |
| Birth place: | - |
| Has resided: | 83 Loveday Street, Birmingham |
| Parish he belongs to: | Birmingham |
| Customary work and mode of life: | No trade |
| Schools attended: | - |
| By whom and where employed: | - |
| State of education: | |
| Reads: | A little |
| Writes: | - |
| Cyphers: | - |
| General ability: | - |
| Offence: | Stealing a paletot and a table cover |
| Circumstances which may have led to it | - |
| Date of sentence: | 23 November 1867 |
| Where convicted: | Moor Street before J Jaffray and F J Welch |
| Who prosecuted: | - |
| Where imprisoned: | - |
| Sentence: | 1 month prison (hard labour), 5 years at Saltley |
| Previous committals and convictions: | Stealing money |
| Father's name: | Dead |
| Occupation: | - |
| Residence: | - |
| Mother's name: | Sarah Jackson |
| Occupation: | Dressmaker |
| Residence: | 83 Loveday Street, Birmingham |
| Father's character: | - |
| Mother's character: | - |
| Parents dead? | - |
| Survivor married again? | - |
| Parents' treatment of child: | Good |
| Character of parents | - |
| Parents' wages: | About 6s per week |
| Amount parents agree to pay: | Not able to pay |
| Superintendent of police (to collect payments): | - |
| Relatives to communicate with: | - |
| Person making this return: | T C S Kynnersley |
| Estimate of character on admission: | - |
| Character on discharge: | - |
| When and how left the Reformatory: | - |
25 November 1867 There is a report of the crime in the Birmingham Daily Post Monday 25 November 1867 p.7 vol.4: A CASE FOR THE REFORMATORY. - William Jackson, a young boy, 12 years of age, was charged with stealing a paletot, and other articles of apparel, from his mother, who stated that since September It was the fourth time that he had robbed her, He pleaded guilty, and was sent one month to the House of Correction, and thereafter to a reformatory for five years.
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