| Occupation as written | Domestic duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 30 May 1910 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 31 May 1910 |
| If rejected, why? | |
| Birthplace as written | Lygumkloster, Slesvig, Denmark |
| Modern country | Denmark |
| Age on application | 50 |
| Age on arrival in Australia | 17 |
| Port of Departure | Denmark |
| Port of Arrival | Sydney |
| Date of arrival | 1 Aug 1876 |
| Name of ship | Samuel Plymsell |
| Voyage | Samuel Plymsell (1876-08-01) |
| Address in Australia | Hostrup, Tuchekoi |
| Address State | Queensland |
| Time at address |
| Previous address 1 | Sydney |
| Address State | New South Wales |
| Time at address |
| Previous address 2 | Brisbane |
| Address State | Queensland |
| Time at address |
| Previous address 3 | Warwick |
| Address State | Queensland |
| Time at address |
| Married | No |
| Children | No |
| Name of reference | Edward Emery Walker |
| Occupation of reference | Justice of the Peace (Queensland) |
| Marginalia description | p.3 - Denmark is crossed out and 'Germany' written (also p.1) |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |