| Occupation as written | Housewife |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 14 Aug 1912 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 15 Aug 1912 |
| If rejected, why? | |
| Birthplace as written | Liegnitz, Selesia, Germany |
| Modern country | Poland |
| Age on application | 63 |
| Age on arrival in Australia | 5 |
| Port of Departure | Germany |
| Port of Arrival | Port Adelaide |
| Date of arrival | 1 Dec 1854 |
| Name of ship | August |
| Voyage | August (1854-12-01) |
| Address in Australia | Nurioolpa |
| Address State | South Australia |
| Time at address | 49 years |
| Previous address 1 | Blumberg (now Birdwood) |
| Address State | South Australia |
| Time at address | 2 years |
| Previous address 2 | Mt Pleasant (2 yrs) and Eden Valley (3 yrs) |
| Address State | South Australia |
| Time at address | 5 years |
| Previous address 3 | Kyneton |
| Address State | Victoria |
| Time at address | 2 years |
| Married | Yes | |
| Children | Yes | 4: 1 son at Hamley Bridge, one daughter at Nurioopsa, 1 at Murray Bridge, and 1 at Adelaide |
| Name of reference | John D A Drinkwater |
| Occupation of reference | State School teacher (South Australia) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |