| Occupation as written | Housekeeper |
| Standardised occupation | DS03: Domestic service - Other service |
| Application received | 3 Jun 1913 |
| Application status | Approved |
| Official | EC |
| Date of approval or denial | 20 Jun 1913 |
| If rejected, why? | |
| Birthplace as written | Warsaw, Poland, Russia |
| Modern country | Poland |
| Age on application | 50 |
| Age on arrival in Australia | 21 |
| Port of Departure | London, England |
| Port of Arrival | Melbourne |
| Date of arrival | 14 Oct 1884 |
| Name of ship | SS Liguria |
| Voyage | Liguria (1884-10-14) |
| Address in Australia | 15 Martin St., Paddington, Sydney |
| Address State | New South Wales |
| Time at address | 2 years |
| Previous address 1 | No. 11 Waterloo St. St Kilda, Melbourne |
| Address State | Victoria |
| Time at address |
| Previous address 2 | Octavia St., Carlton |
| Address State | Victoria |
| Time at address | 7 years |
| Married | Yes | |
| Children | Yes | 1 boy, living with her |
| Name of reference | William Thomas Fraser |
| Occupation of reference | Public School Teacher, New South Wales |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |