| Occupation as written | married woman |
| Standardised occupation | XX00: Other - Other |
| Application received | 27 May 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 1 Jun 1911 |
| If rejected, why? | |
| Birthplace as written | Claasdorf, near Deutsch Klone, West Prussia |
| Modern country | Poland |
| Age on application | 73 |
| Age on arrival in Australia | 40 |
| Port of Departure | Germany |
| Port of Arrival | Adelaide |
| Date of arrival | 25 Jun 1878 |
| Name of ship | Edward |
| Voyage | Eduard (1878-06-17) |
| Address in Australia | near Robertstown |
| Address State | South Australia |
| Time at address | 4 years |
| Previous address 1 | Point Pass |
| Address State | South Australia |
| Time at address | 11 years |
| Previous address 2 | Bundey |
| Address State | South Australia |
| Time at address | 18 years |
| Previous address 3 | Bright, near Robertstown |
| Address State | South Australia |
| Time at address | 4 years |
| Married | Yes | |
| Children | Yes | 4: 3 sons 1 daughter |
| Name of reference | Carl Friedrich Leditschke |
| Occupation of reference | Justice of the Peace (South Australia) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | N/A |
| Other information |