| Occupation as written | Housewife |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 1 Nov 1909 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 3 Dec 1909 |
| If rejected, why? | |
| Birthplace as written | Philidelphia, United States of America |
| Modern country | United States of America |
| Age on application | 61 |
| Age on arrival in Australia | 15 |
| Port of Departure | New York |
| Port of Arrival | Port Phillip, Victoria |
| Date of arrival | 1 Nov 1863 |
| Name of ship | Aurora |
| Voyage | Aurora (1863-11-01) |
| Address in Australia | 28 Little Elgin Street, Carlton |
| Address State | Victoria |
| Time at address | 22 years |
| Previous address 1 | Ballarat |
| Address State | Victoria |
| Time at address | 8 years |
| Previous address 2 | Clunes |
| Address State | Victoria |
| Time at address | 16 years |
| Married | Widow | |
| Children | Yes | 5: three boys and two girls, all in Victoria. |
| Name of reference | Michael Quinn |
| Occupation of reference | Police Constable, Carlton, Victoria |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |