| Occupation as written | no occupation |
| Standardised occupation | XX00: Other - Other |
| Application received | 10 Feb 1913 |
| Application status | Approved |
| Official | EC |
| Date of approval or denial | 19 Feb 1913 |
| If rejected, why? | |
| Birthplace as written | Jarnac, Charente, France |
| Modern country | France |
| Age on application | 70 |
| Age on arrival in Australia | 44 |
| Port of Departure | France |
| Port of Arrival | Melbourne |
| Date of arrival | 16 Apr 1886 |
| Name of ship | Oceanian |
| Voyage | Oceanien (1886-04-16) |
| Address in Australia | 74 Carlisle Street, Saint Kilda |
| Address State | Victoria |
| Time at address |
| Previous address 1 | Brunswick |
| Address State | Victoria |
| Time at address | 12 years |
| Previous address 2 | South Yarra, Melbourne |
| Address State | Victoria |
| Time at address | 14 years |
| Married | Widow | |
| Children | Yes | 4, all female |
| Name of reference | John H. Pittard |
| 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 |