| Occupation as written | Tailoress |
| Standardised occupation | MF23: Manufacturing - Dress |
| Application received | 5 Sep 1910 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 6 Sep 1910 |
| If rejected, why? | |
| Birthplace as written | Tolla, Poland |
| Modern country | Poland |
| Age on application | 60 |
| Age on arrival in Australia | 35 |
| Port of Departure | London, England |
| Port of Arrival | Fremantle |
| Date of arrival | 23 May 1885 |
| Name of ship | Glen Arow |
| Voyage | Glen Arow (1885-05-23) |
| Address in Australia | 107 Lake St. Perth |
| Address State | Western Australia |
| Time at address |
| Married | Yes | |
| Children | Yes | 6: 4 girls and 2 boys |
| Name of reference | Robert Connell |
| Occupation of reference | Inspector of Police, Western Australia |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | N/A |
| Other information |