| Occupation as written | Household duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 23 Jun 1910 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 23 Jun 1910 |
| If rejected, why? | |
| Birthplace as written | Liegnitz, Prussia, Germany |
| Modern country | Poland |
| Age on application | 70 |
| Age on arrival in Australia | 9 |
| Port of Departure | Hamburg |
| Port of Arrival | Melbourne |
| Date of arrival | 8 Mar 1849 |
| Name of ship | Wappeus |
| Voyage | Wappeus (1849-03-08) |
| Address in Australia | 103 George St. Fitzroy |
| Address State | Victoria |
| Time at address | 45 years |
| Married | Widow |
| Children | No |
| Name of reference | Alexander Renfrew |
| Occupation of reference | Justice of the Peace (Victoria) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |