| Occupation as written | domestic duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 2 May 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 4 May 1911 |
| If rejected, why? | |
| Birthplace as written | Haide, Germany |
| Modern country | Germany |
| Age on application | 69 |
| Age on arrival in Australia | 29 |
| Port of Departure | Germany |
| Port of Arrival | Maryborough |
| Date of arrival | 1 Jun 1870 |
| Name of ship | Reistag |
| Voyage | Reichstag (1870-06-01) |
| Address in Australia | North Croydon |
| Address State | Queensland |
| Time at address | 24 years |
| Previous address 1 | Maryborough and Rockhampton |
| Address State | Queensland |
| Time at address | 7 years |
| Previous address 2 | Tambo |
| Address State | Queensland |
| Time at address | 4 years |
| Previous address 3 | Aranae (6 mo), Winston (7 yrs) Hughendon (1 yr) |
| Address State | |
| Time at address |
| Married | Widow | |
| Children | Yes | 1 son, residence unknown |
| Name of reference | Timothy Sullivan |
| Occupation of reference | Sergeant of Police (Queensland) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |