| Occupation as written | Domestic Duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 25 Aug 1913 |
| Application status | Approved |
| Official | CSS |
| Date of approval or denial | 3 Mar 1914 |
| If rejected, why? | |
| Birthplace as written | Skosoora near Copenhagen, Denmark |
| Modern country | Denmark |
| Age on application | 60 |
| Age on arrival in Australia | 25 |
| Port of Departure | Denmark |
| Port of Arrival | Rockhampton |
| Date of arrival | 1 Jan 1880 |
| Name of ship | None |
| Address in Australia | Mrs Peterson, known as Mrs A C Johnson, c/o Mrs Camars Farm, Mundinghurra, near Townsville, Queensland |
| Address State | Queensland |
| Time at address |
| Previous address 1 | Bowen |
| Address State | Queensland |
| Time at address | 6 months |
| Previous address 2 | Townsville |
| Address State | Queensland |
| Time at address | 35 years |
| Previous address 3 | Ipswich |
| Address State | Queensland |
| Time at address | 3 years |
| Married | Widow |
| Children | No |
| Name of reference | James Portley |
| Occupation of reference | Police Constable, Queensland |
| Marginalia description | p.1 'Dane' |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | N/A |
| Other information |