| Occupation as written | Domestic Duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 1 May 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 11 May 1911 |
| If rejected, why? | |
| Birthplace as written | Cuba |
| Modern country | Cuba |
| Age on application | 66 |
| Age on arrival in Australia | 1 |
| Port of Departure | England |
| Port of Arrival | Melbourne |
| Date of arrival | 1 Jan 1847 |
| Name of ship | Great Britain |
| Voyage | Great Britain (1847-01-01) |
| Address in Australia | Dondas |
| Address State | New South Wales |
| Time at address | 25 years |
| Previous address 1 | Melboune |
| Address State | Victoria |
| Time at address | 40 years |
| Married | Widow | |
| Children | Yes | 1 son residing with her |
| Name of reference | Charles Edwin Rawlinson |
| Occupation of reference | Justice of the Peace (New South Wales) |
| Marginalia description | 'French' written on p.2 next to 'Cuban' (they had written and asked, p.1, 5 May - presumably this was from missing reply) |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | Pension |
| Other information | 28/4/1911, p.5 - Doctor and James Douglas, Commissioner Pensions, working together to sort out paperwork so she can get the invalid pension |