| Occupation as written | married |
| Standardised occupation | XX00: Other - Other |
| Application received | 4 Apr 1911 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 24 May 1911 |
| If rejected, why? | |
| Birthplace as written | Kay, Germany |
| Modern country | Poland |
| Age on application | 65 |
| Age on arrival in Australia | 6 |
| Port of Departure | Hamburg |
| Port of Arrival | Adelaide |
| Date of arrival | 1 Jan 1851 |
| Name of ship | San Francisco |
| Voyage | San Francisco (1851-01-01) |
| Address in Australia | 107 Pulteney Street Adelaide |
| Address State | South Australia |
| Time at address |
| Previous address 1 | Parkside, Hyde Park & Adelaide |
| Address State | South Australia |
| Time at address | 24 years |
| Previous address 2 | Springton Eden Valley Gawler |
| Address State | South Australia |
| Time at address |
| Married | Yes | |
| Children | Yes | 5: 4 sons, 2 daughters. 3 sons in Adelaide, 1 son in Victoria, 1 daughter in Kadima S.A. |
| Name of reference | Roy Morley |
| Occupation of reference | Police Constable, South Australia |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |