| Occupation as written | Domestic duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 17 Jun 1912 |
| Application status | Approved |
| Official | GB |
| Date of approval or denial | 22 Jun 2019 |
| If rejected, why? | |
| Birthplace as written | Grossdomar, Poland |
| Modern country | Poland |
| Age on application | 64 |
| Age on arrival in Australia | 9 |
| Port of Departure | Poland |
| Port of Arrival | Port Adelaide |
| Date of arrival | 18 Aug 1856 |
| Name of ship | August |
| Voyage | August (1856-08-04) |
| Address in Australia | Wilcannia and Silveton |
| Address State | New South Wales |
| Time at address | 25 years |
| Previous address 1 | Various places |
| Address State | South Australia |
| Time at address | 30 years |
| Married | Yes | |
| Children | Yes | 8: 6 boys and 2 females. Four sons live in South Australia, one in Queensland, and one in New Zealand. Two daughters live in Broken Hill and Wilcannia respectively. |
| Name of reference | Ernest Gey Dollman |
| Occupation of reference | Justice of the Peace (New South Wales) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |