| Occupation as written | General Servant |
| Standardised occupation | DS01: Domestic service - Indoor service |
| Application received | 27 Mar 1910 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 29 Mar 1910 |
| If rejected, why? | |
| Birthplace as written | Cjesvor, Norway |
| Modern country | Norway |
| Age on application | 56 |
| Age on arrival in Australia | 24 |
| Port of Departure | Norway |
| Port of Arrival | Rockhampton |
| Date of arrival | 2 Mar 1879 |
| Name of ship | Charles Dickens |
| Voyage | Charles Wakin (1879-03-01) |
| Address in Australia | Brisbane |
| Address State | Queensland |
| Time at address | 25 years |
| Previous address 1 | Maryborough |
| Address State | Queensland |
| Time at address | 2 years |
| Previous address 2 | Gympie |
| Address State | Queensland |
| Time at address | 1 years |
| Previous address 3 | Sydney (2 yrs), Western Australia (2 yrs) |
| Address State | |
| Time at address |
| Married | Widow | |
| Children | Yes | 3: 2 sons and 1 daughter. 1 son at Mackay and the others at Brisbane. |
| Name of reference | Michael Kyran Rockett |
| Occupation of reference | Constable of Police, Queensland |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |