| Occupation as written | Shop keeper |
| Standardised occupation | DE12: Dealing - General dealers |
| Application received | 1 Jan 1904 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 24 Aug 1904 |
| If rejected, why? | |
| Birthplace as written | Nassau on Rhine, Germany |
| Modern country | Germany |
| Age on application | 56 |
| Age on arrival in Australia | 6 |
| Port of Departure | Antwerp |
| Port of Arrival | Sydney |
| Date of arrival | 1 Mar 1854 |
| Name of ship | None |
| Address in Australia | 68 Macquarrie Street, South Sydney. |
| Address State | New South Wales |
| Time at address |
| Previous address 1 | Hill End |
| Address State | New South Wales |
| Time at address | 7 years |
| Previous address 2 | Mudgee |
| Address State | New South Wales |
| Time at address | 2 years |
| Previous address 3 | Camden |
| Address State | New South Wales |
| Time at address | 10 years |
| Married | Widow | |
| Children | Yes | 7: Four girls and three boys, one boy residing in Western Australia, and the rest in Sydney. |
| Name of reference | John Slamon |
| Occupation of reference | Sergeant of Police, Balmein, NSW |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | N/A |
| Other information |
no ship