| Occupation as written | widow |
| Standardised occupation | XX00: Other - Other |
| Application received | 21 Sep 1914 |
| Application status | Approved |
| Official | GB |
| Date of approval or denial | 6 Oct 1914 |
| If rejected, why? | |
| Birthplace as written | Limerick, Ireland |
| Modern country | Ireland |
| Age on application | 75 |
| Age on arrival in Australia | 21 |
| Port of Departure | None |
| Port of Arrival | None |
| Date of arrival | None |
| Name of ship | None |
| Address in Australia | Cournd Lap |
| Address State | Victoria |
| Time at address | 48 years |
| Previous address 1 | Ballarat |
| Address State | Victoria |
| Time at address | 3 years |
| Previous address 2 | Geelong |
| Address State | Victoria |
| Time at address | 2 years |
| Married | Widow |
| Children | No |
| Name of reference | Ernest Day |
| Occupation of reference | Constable of Police (Victoria) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | Pension |
| Other information | Cover letter says applying for old age pension |