| Occupation as written | Domestic duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 1 Jan 1904 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 6 Jan 1905 |
| If rejected, why? | |
| Birthplace as written | Enebok, Christiansand, Norway |
| Modern country | Norway |
| Age on application | 63 |
| Age on arrival in Australia | 30 |
| Port of Departure | Norway |
| Port of Arrival | Townsville, Queensland |
| Date of arrival | 1 Aug 1872 |
| Name of ship | Humboldt |
| Voyage | Humboldt (1872-08-01) |
| Address in Australia | 22 1/2 Argylle Street, Sydney |
| Address State | New South Wales |
| Time at address | 32 years, 2 months |
| Previous address 1 | Toowoomba |
| Address State | Queensland |
| Time at address |
| Married | Widow | |
| Children | Yes | 4: one boy and three girls |
| Name of reference | Davey |
| Occupation of reference | Justice of the Peace (New South Wales) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | N/A |
| Other information |