| Occupation as written | Household duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 15 Mar 1909 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 23 Apr 1909 |
| If rejected, why? | |
| Birthplace as written | Raddeausch, Krkau, Germany |
| Modern country | Poland |
| Age on application | 74 |
| Age on arrival in Australia | 53 |
| Port of Departure | Germany |
| Port of Arrival | Brisbane |
| Date of arrival | 18 Oct 1887 |
| Name of ship | Waroonga |
| Voyage | Waroonga (1887-10-17) |
| Address in Australia | Mount Sylvia |
| Address State | Queensland |
| Time at address |
| Previous address 1 | Tarampa |
| Address State | Queensland |
| Time at address | 2 years |
| Married | Widow | |
| Children | Yes | 2: son and a daughter, both live in Mount Sylvia. |
| Name of reference | John Francis Lobb |
| Occupation of reference | Justice of the Peace (Queensland) |
| Marginalia description | p.1 'German' |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |