| Occupation as written | Domestic Duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 12 Sep 1912 |
| Application status | Approved |
| Official | LTF |
| Date of approval or denial | 8 Oct 1912 |
| If rejected, why? | |
| Birthplace as written | Stettin, Pommern, Germany |
| Modern country | Poland |
| Age on application | 37 |
| Age on arrival in Australia | 35 |
| Port of Departure | Berlin |
| Port of Arrival | Brisbane |
| Date of arrival | 30 May 1910 |
| Name of ship | Osterley |
| Voyage | Osterley (1910-06-01) |
| Address in Australia | Mount Larcom |
| Address State | Queensland |
| Time at address | 1 years, 9 months |
| Previous address 1 | Ambrose Siding, Milman |
| Address State | Queensland |
| Time at address | 6 years |
| Married | Yes | |
| Children | Yes | 2 sons |
| Name of reference | Alfred Gourney |
| 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 |