| Occupation as written | not able to do anything |
| Standardised occupation | XX00: Other - Other |
| Application received | 19 Apr 1913 |
| Application status | Approved |
| Official | A.H. |
| Date of approval or denial | 3 May 1913 |
| If rejected, why? | |
| Birthplace as written | Coser on Oda, Germany |
| Modern country | Germany |
| Age on application | 78 |
| Age on arrival in Australia | 20 |
| Port of Departure | Coser on Oda, Germany |
| Port of Arrival | Port Adelaide |
| Date of arrival | 3 Sep 1855 |
| Name of ship | Laroschelle |
| Voyage | La Rochelle (1855-09-15) |
| Address in Australia | with my daughter Mannum |
| Address State | South Australia |
| Time at address | 1 years |
| Previous address 1 | Tableland |
| Address State | South Australia |
| Time at address | 43 years |
| Previous address 2 | Truro |
| Address State | South Australia |
| Time at address | 15 years |
| Married | Widow | |
| Children | Yes | 3: 2 sons and 1 daughter. Another 1 daughter and 2 sons dead. |
| Name of reference | Waller Jams Webb |
| Occupation of reference | Justice of the Peace (South Australia) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | Pension |
| Other information |
disabled?