| Occupation as written | housekeeper |
| Standardised occupation | DS03: Domestic service - Other service |
| Application received | 20 Jul 1912 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 20 Jul 1912 |
| If rejected, why? | |
| Birthplace as written | Stettin, Pommern, Germany |
| Modern country | Poland |
| Age on application | 53 |
| Age on arrival in Australia | 13 |
| Port of Departure | Germany |
| Port of Arrival | Rockhampton |
| Date of arrival | 1 Jan 1872 |
| Name of ship | SS Shakespeare |
| Voyage | Shakespeare (1872-10-01) |
| Address in Australia | Rockhampton |
| Address State | Queensland |
| Time at address | 32 years |
| Previous address 1 | Blackall |
| Address State | Queensland |
| Time at address | 8 years |
| Married | Yes | |
| Children | Yes | 5: 2 boys and 3 girls. 1 daughter at Tambo (married) and one at Blackall (Married) |
| Name of reference | Walter Stanworth Chapple |
| Occupation of reference | Justice of the Peace (Queensland) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |