| Occupation as written | Cook |
| Standardised occupation | MF25: Manufacturing - Food preparation |
| Application received | 1 Jan 1904 |
| Application status | Approved |
| Official | LTF |
| Date of approval or denial | 6 Feb 1904 |
| If rejected, why? | |
| Birthplace as written | Pensylvania, America |
| Modern country | United States of America |
| Age on application | 67 |
| Age on arrival in Australia | 20 |
| Port of Departure | England |
| Port of Arrival | Melbourne |
| Date of arrival | 1 Jan 1856 |
| Name of ship | Salem |
| Voyage | Salem (1856-01-01) |
| Address in Australia | Melbourne |
| Address State | Victoria |
| Time at address | 2 years |
| Previous address 1 | Vincent Street, Dayslesford |
| Address State | Victoria |
| Time at address | 45 years |
| Married | Widow |
| Children | No |
| Name of reference | M. Barkas |
| Occupation of reference | Justice of the Peace (Victoria) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |