| Occupation as written | - |
| Standardised occupation | XX00: Other - Other |
| Application received | 1 Apr 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 3 Apr 1911 |
| If rejected, why? | |
| Birthplace as written | Hadderslev, Schleswick, Denmark |
| Modern country | Denmark |
| Age on application | 67 |
| Age on arrival in Australia | 33 |
| Port of Departure | New Zealand |
| Port of Arrival | Melbourne |
| Date of arrival | 25 Jul 1877 |
| Name of ship | USS Roforma |
| Voyage | Roforma (1877-07-25) |
| Address in Australia | 33 King Street, Prahran, Melbourne |
| Address State | Victoria |
| Time at address | 16 years |
| Previous address 1 | Williamstown |
| Address State | Victoria |
| Time at address | 14 years |
| Previous address 2 | Richmond |
| Address State | Victoria |
| Time at address | 3 years |
| Married | Yes | |
| Children | Yes | 5 boys (one dead) - living in Prahran, Yarra, Elsternwick, and Williamstown. |
| Name of reference | Alexander Rasmussen |
| Occupation of reference | State School Teacher, Victoria |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |
She puts no occupation