| Occupation as written | Blocker |
| Standardised occupation | MF24: Manufacturing - Dress sundries |
| Application received | 11 May 1912 |
| Application status | Approved |
| Official | CSS |
| Date of approval or denial | 14 May 1912 |
| If rejected, why? | |
| Birthplace as written | Rädnitz, Prussia, Germany |
| Modern country | Poland |
| Age on application | 63 |
| Age on arrival in Australia | 32 |
| Port of Departure | Germany |
| Port of Arrival | Adelaide |
| Date of arrival | 1 Oct 1881 |
| Name of ship | Sterlingshire |
| Voyage | Stirlingshire (1881-09-22) |
| Address in Australia | Millicent Road, near Mt Gambier |
| Address State | South Australia |
| Time at address | 10 years |
| Previous address 1 | Point Pass |
| Address State | South Australia |
| Time at address | 2 years |
| Previous address 2 | Robertstown |
| Address State | South Australia |
| Time at address | 19 years |
| Married | Yes | |
| Children | Yes | 5: 3 sons and 2 daughters, both in area |
| Name of reference | Eugen Johann Adolf Kiselbach |
| Occupation of reference | Justice of the Peace (South Australia) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |