| Occupation as written | Caretaker |
| Standardised occupation | DS02: Domestic service - Outdoor service |
| Application received | 28 Oct 1909 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 2 Dec 1909 |
| If rejected, why? | |
| Birthplace as written | Nieolai, Schlesien, Germany |
| Modern country | Germany |
| Age on application | 48 |
| Age on arrival in Australia | 17 |
| Port of Departure | Germany |
| Port of Arrival | Adelaide |
| Date of arrival | 17 Feb 1877 |
| Name of ship | Horshel |
| Voyage | Herschel (1877-01-03) |
| Address in Australia | Princes Building, Perth |
| Address State | Western Australia |
| Time at address | 14 years |
| Previous address 1 | Victoria |
| Address State | Victoria |
| Time at address | 6 years |
| Previous address 2 | Tasmania |
| Address State | Tasmania |
| Time at address | 1 years |
| Previous address 3 | South Austalia |
| Address State | South Australia |
| Time at address | 12 years |
| Married | Yes | |
| Children | Yes | 5: Three boys and two girls in Perth, Western Australia. |
| Name of reference | Arthur Pilgrim Amies |
| Occupation of reference | Justice of the Peace, Westerrn Australia |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |