| Occupation as written | Home duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 1 Jan 1911 |
| Application status | Approved |
| Official | CSS |
| Date of approval or denial | 1 Nov 1911 |
| If rejected, why? | |
| Birthplace as written | Copenhagen, Denmark |
| Modern country | Denmark |
| Age on application | 31 |
| Age on arrival in Australia | 8 |
| Port of Departure | Copenhagen |
| Port of Arrival | Bundaberg, Queensland |
| Date of arrival | 1 Jan 1888 |
| Name of ship | None |
| Address in Australia | Knockroe Road, Childers |
| Address State | Queensland |
| Time at address | 2 years, 6 months |
| Previous address 1 | Sydney |
| Address State | New South Wales |
| Time at address | 4 years |
| Previous address 2 | Charters Towers |
| Address State | Queensland |
| Time at address | 11 months |
| Previous address 3 | Bundaberg |
| Address State | Queensland |
| Time at address | 15 years, 7 months |
| Married | Yes | |
| Children | Yes | 2: 1 boy and 1 girl. |
| Name of reference | John Macoheto |
| Occupation of reference | Police Magistrate, Queensland |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |
No date for ship arrival