| Occupation as written | Farmers Household Duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 21 Aug 1916 |
| Application status | Already a Subject |
| Official | LTF |
| Date of approval or denial | 6 Sep 1916 |
| If rejected, why? | |
| Birthplace as written | Nieborze, Germany |
| Modern country | Poland |
| Age on application | 46 |
| Age on arrival in Australia | 13 |
| Port of Departure | Hamburg |
| Port of Arrival | Port Adelaide |
| Date of arrival | 1 Jul 1883 |
| Name of ship | Catania |
| Voyage | Catania (1883-07-17) |
| Address in Australia | Gawler River |
| Address State | South Australia |
| Time at address | 25 years |
| Previous address 2 | Snowtown |
| Address State | South Australia |
| Time at address | 6 years |
| Married | Yes | |
| Children | Yes | 5 sons |
| Name of reference | William Henry Cox |
| 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 |