| Occupation as written | Housewife |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 24 Mar 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 25 Mar 1911 |
| If rejected, why? | |
| Birthplace as written | Lingen, Wurttemburg, Germany |
| Modern country | Germany |
| Age on application | 33 |
| Age on arrival in Australia | 23 |
| Port of Departure | Bremerhaven |
| Port of Arrival | Fremantle |
| Date of arrival | 11 Nov 1901 |
| Name of ship | Bremen |
| Voyage | Bremen (1901-11-11) |
| Address in Australia | Carrington Street, Fremantle |
| Address State | Western Australia |
| Time at address | 3 years |
| Previous address 1 | Headland |
| Address State | Western Australia |
| Time at address | 6 years |
| Married | Yes | |
| Children | Yes | 3: two males and one female |
| Name of reference | Max Heiehard |
| Occupation of reference | Police Constable, Western Australia |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |