| Occupation as written | Household Duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 1 Dec 1912 |
| Application status | Approved |
| Official | LTF |
| Date of approval or denial | 21 Dec 1912 |
| If rejected, why? | |
| Birthplace as written | Glenroy, Victoria |
| Modern country | Australia |
| Age on application | 68 |
| Age on arrival in Australia | None |
| Port of Departure | None |
| Port of Arrival | None |
| Date of arrival | None |
| Name of ship | None |
| Address in Australia | 3 Hertford St. Fitzroy |
| Address State | Victoria |
| Time at address |
| Married | Yes | |
| Children | Yes | 2 daughters |
| Name of reference | James Ramsay McPherson |
| Occupation of reference | Sergeant of Police, Victoria |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |