| Occupation as written | wife |
| Standardised occupation | XX00: Other - Other |
| Application received | 10 Jan 1910 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 12 Jan 1911 |
| If rejected, why? | |
| Birthplace as written | Schyern near Crossen, Prussia, Germany |
| Modern country | Germany |
| Age on application | 59 |
| Age on arrival in Australia | 9 |
| Port of Departure | Germany |
| Port of Arrival | Adelaide |
| Date of arrival | 1 Nov 1860 |
| Name of ship | None |
| Address in Australia | Stockwell Miller |
| Address State | South Australia |
| Time at address | 25 years |
| Previous address 1 | Tanunda |
| Address State | South Australia |
| Time at address | 15 years |
| Previous address 2 | Lyndoch |
| Address State | South Australia |
| Time at address | 7 years |
| Married | Yes | |
| Children | Yes | 6: 5 sons and 1 daughter |
| Name of reference | Carl von Bertouch |
| 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 |