| Occupation as written | Housekeeper |
| Standardised occupation | DS01: Domestic service - Indoor service |
| Application received | 20 Nov 1909 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 3 Dec 1909 |
| If rejected, why? | |
| Birthplace as written | Tocsana, Florence, Italy |
| Modern country | Italy |
| Age on application | 64 |
| Age on arrival in Australia | 31 |
| Port of Departure | Florence |
| Port of Arrival | Maryborough, Queensland |
| Date of arrival | 1 Jan 1876 |
| Name of ship | Amnershagen |
| Voyage | Lammashagen (1876-01-18) |
| Address in Australia | Yurillo Street, Geelong, West |
| Address State | Victoria |
| Time at address | 7 years |
| Previous address 1 | Melbourne |
| Address State | Victoria |
| Time at address | 25 years |
| Previous address 2 | Sydney |
| Address State | New South Wales |
| Time at address | 1 years |
| Previous address 3 | Maryborough |
| Address State | Queensland |
| Time at address | 6 months |
| Married | Yes | |
| Children | Yes | 2 |
| Name of reference | Thomas Oliver Gorman |
| Occupation of reference | Justice of the Peace (Victoria) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |