| Occupation as written | Farmer |
| Standardised occupation | AG01: Agriculture - Farming/Land Service |
| Application received | 22 Apr 1913 |
| Application status | Approved |
| Official | LTF |
| Date of approval or denial | 12 May 1913 |
| If rejected, why? | |
| Birthplace as written | Pirie Hill, Belyando, Queensland |
| Modern country | Australia |
| Age on application | 29 |
| Age on arrival in Australia | None |
| Port of Departure | None |
| Port of Arrival | None |
| Date of arrival | None |
| Name of ship | None |
| Address in Australia | Tolga |
| Address State | Queensland |
| Time at address | 8 years |
| Previous address 1 | Croydon |
| Address State | Queensland |
| Time at address | 15 years |
| Previous address 2 | Pine Hill |
| Address State | Queensland |
| Time at address | 6 years |
| Married | Widow | |
| Children | Yes | 5 daughters |
| Name of reference | Harold Morton Taylor |
| Occupation of reference | Justice of the Peace (Queensland) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | Recently widowed |
| Other information | "I was married to Stephen Poletti, a native of Italy, proof of whose naturalization cannot be found." |