| Occupation as written | Domestic duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 11 Mar 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 3 Apr 1911 |
| If rejected, why? | |
| Birthplace as written | Marienwerder, Prussia |
| Modern country | Germany |
| Age on application | 51 |
| Age on arrival in Australia | 22 |
| Port of Departure | None |
| Port of Arrival | None |
| Date of arrival | None |
| Name of ship | None |
| Address in Australia | 240 Crown Street, Darlinghurst, Sydney |
| Address State | New South Wales |
| Time at address | 29 years |
| Previous address 1 | Brisbane |
| Address State | Queensland |
| Time at address | 2 years |
| Married | Yes | |
| Children | Yes | One child, a girl, living in Sydney. |
| Name of reference | James Dixson |
| Occupation of reference | Justice of the Peace (New South Wales) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |