| Occupation as written | no occupation |
| Standardised occupation | XX00: Other - Other |
| Application received | 28 Mar 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 30 Mar 1911 |
| If rejected, why? | |
| Birthplace as written | Norcia, Perugia, Italy |
| Modern country | Italy |
| Age on application | 45 |
| Age on arrival in Australia | 43 |
| Port of Departure | Italy |
| Port of Arrival | Adelaide |
| Date of arrival | 16 Oct 1908 |
| Name of ship | Seydlitz |
| Voyage | Seydlitz (1908-10-17) |
| Address in Australia | 281 Angas Street, Adelaide |
| Address State | South Australia |
| Time at address |
| Married | Yes | |
| Children | Yes | 4: 3 males and 1 female who reside with her |
| Name of reference | Roger Florence Charles Sullivan |
| Occupation of reference | Justice of the Peace (South Australia) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |