| Occupation as written | Domestic |
| Standardised occupation | DS03: Domestic service - Other service |
| Application received | 1 Nov 1912 |
| Application status | Approved |
| Official | GB |
| Date of approval or denial | 4 Nov 1912 |
| If rejected, why? | |
| Birthplace as written | Lauenburg on the Elbe, Germany |
| Modern country | Germany |
| Age on application | 79 |
| Age on arrival in Australia | 22 |
| Port of Departure | Hamburg |
| Port of Arrival | Hobart Tasmania |
| Date of arrival | 1 Jan 1854 |
| Name of ship | Lowe von Lilienstein |
| Voyage | Lowe von Lilienstein (1854-01-01) |
| Address in Australia | Newington Asylum, Newington |
| Address State | New South Wales |
| Time at address |
| Married | Widow | |
| Children | Yes | 3, 1 living son, 'his present whereaboutts is unknown to me.' |
| Name of reference | W Bradley Violette |
| Occupation of reference | Justice of the Peace (New South Wales) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | Pension |
| Other information | p.12 |