| Occupation as written | Household Duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 10 Oct 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 12 Oct 1911 |
| If rejected, why? | |
| Birthplace as written | Labiskin, Posen, Germany |
| Modern country | Germany |
| Age on application | 64 |
| Age on arrival in Australia | 14 |
| Port of Departure | Posen, Germany |
| Port of Arrival | Adelaide |
| Date of arrival | 16 Sep 1861 |
| Name of ship | Zsarbrook |
| Voyage | Zsarbrook (1861-09-16) |
| Address in Australia | 76 Sydenham Road, Norwood |
| Address State | South Australia |
| Time at address | 42 years |
| Married | Yes |
| Children | No |
| Name of reference | Ernest Oswald Gooden |
| Occupation of reference | Justice of the Peace (South Australia) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |