| Occupation as written | Housewife |
| Standardised occupation | DS01: Domestic service - Indoor service |
| Application received | 17 Aug 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 22 Jul 1911 |
| If rejected, why? | |
| Birthplace as written | Gimatta, Nevaso, Italy |
| Modern country | Italy |
| Age on application | 66 |
| Age on arrival in Australia | 34 |
| Port of Departure | Italy |
| Port of Arrival | Sydney |
| Date of arrival | 1 Apr 1881 |
| Name of ship | James Patterson |
| Voyage | James Patterson (1881-04-01) |
| Address in Australia | Gunduriaba, Richmond River |
| Address State | New South Wales |
| Time at address | 3 years |
| Married | Yes | |
| Children | Yes | 8 children, 5 girls and 3 boys |
| Name of reference | Frederick Edward Servenir |
| Occupation of reference | Justice of the Peace (New South Wales) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | other |
| Other information | p.8 - over 50 years residence |