| Occupation as written | No occupation |
| Standardised occupation | XX00: Other - Other |
| Application received | 6 Aug 1910 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 27 Aug 1910 |
| If rejected, why? | |
| Birthplace as written | Havre, France |
| Modern country | France |
| Age on application | 59 |
| Age on arrival in Australia | 30 |
| Port of Departure | Havre |
| Port of Arrival | Sydney |
| Date of arrival | 1 Jan 1881 |
| Name of ship | Boswith |
| Voyage | Boswith (1881-01-01) |
| Address in Australia | Sydney |
| Address State | New South Wales |
| Time at address |
| Previous address 1 | Numagee (possibly Nymagee in NSW) |
| Address State | New South Wales |
| Time at address | 1 years |
| Previous address 2 | Dubbo |
| Address State | New South Wales |
| Time at address | 1 years, 6 months |
| Previous address 3 | Bourke |
| Address State | New South Wales |
| Time at address | 2 years |
| Married | Yes |
| Children | No |
| Name of reference | J.P. Rochair |
| Occupation of reference | Detective Police Officer, New South Wales |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | N/A |
| Other information |