| Occupation as written | Music Teacher |
| Standardised occupation | PP13: Public services and Professionals - Education |
| Application received | 7 May 1917 |
| Application status | Approved |
| Official | GB |
| Date of approval or denial | 7 May 1917 |
| If rejected, why? | |
| Birthplace as written | Vilna, Poland, Russia (Russian Pole) |
| Modern country | Lithuania |
| Age on application | 69 |
| Age on arrival in Australia | 32 |
| Port of Departure | Moulmein, Burma |
| Port of Arrival | Albany |
| Date of arrival | 29 Feb 1880 |
| Name of ship | Shannon |
| Voyage | Shannon (1880-02-29) |
| Address in Australia | Albany |
| Address State | Western Australia |
| Time at address | 18 years |
| Previous address 1 | Fremantle |
| Address State | Western Australia |
| Time at address | 11 years |
| Previous address 2 | Northam |
| Address State | Western Australia |
| Time at address | 8 years |
| Married | No |
| Children | No |
| Name of reference | John Hevir |
| Occupation of reference | Justice of the Peace (Western Australia) |
| Marginalia description | p.1 'female - R' |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |