| No. in Admissions Register: | 375 |
| Date of admission: | 9 January 1868 |
| Whence received: | Stafford |
| 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? | Cowpox |
| Particular marks: | - |
| Cutaneous disorder? | No |
| Scrofulous or consumptive? | Not apparent |
| Subject to fits? | No |
| Age last birthday: | 11 |
| Illegitimate? | - |
| Birthday: | - |
| Birth place: | - |
| Has resided: | Nethertown near Yoxall, Staffordshire |
| Parish he belongs to: | Yoxall |
| Customary work and mode of life: | Farm work |
| Schools attended: | - |
| By whom and where employed: | - |
| State of education: | |
| Reads: | Not at all |
| Writes: | Not at all |
| Cyphers: | - |
| General ability: | - |
| Offence: | Stealing a watch |
| Circumstances which may have led to it: | - |
| Date of sentence: | [19 December 1867] |
| Where convicted: | [Rugeley before T J Birch and J W Sneyd] |
| Who prosecuted: | - |
| Where imprisoned: | - |
| Sentence: | 21 days prison (hard labour), 5 years at Saltley |
| Previous committals and convictions: | None |
| Father's name: | - |
| Occupation: | - |
| Residence: | - |
| Mother's name: | Jane Goring |
| Occupation: | works on a farm |
| Residence: | Nethertown, Hamstall Ridware, Rugeley, Staffordshire |
| Father's character: | - |
| Mother's character: | - |
| Parents dead? | Father |
| Survivor married again? | No |
| Parents' treatment of child: | Good |
| Character of parents | Honest, rather given to drink, health good |
| Parents' wages: | About 3s per week besides son's earnings |
| Amount parents agree to pay: | Nothing |
| Superintendent of police (to collect payments): | - |
| Relatives to communicate with: | - |
| Person making this return: | - |
| Estimate of character on admission: | - |
| Character on discharge: | - |
| When and how left the Reformatory: | - |
21 December 1867 There is a brief report of the crime in the Staffordshire Advertiser Saturday 21 December 1867 p.7 col.3: LARCENY. - Samuel Goring of Hamstall Ridware, a boy between ten and eleven years of age, was convicted of stealing a watch, the property of John Lawrance. on the 1st inst., and the Bench sentenced him to three weeks' imprisonment, and at the expiration of that sentence to be sent to a reformatory for five years.
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