| Occupation as written | widow |
| Standardised occupation | XX00: Other - Other |
| Application received | 26 Sep 1913 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 26 Sep 1913 |
| If rejected, why? | |
| Birthplace as written | Leignitz, Germany |
| Modern country | Poland |
| Age on application | 81 |
| Age on arrival in Australia | 22 |
| Port of Departure | Liegnity |
| Port of Arrival | None |
| Date of arrival | 1 Mar 1854 |
| Name of ship | Australian |
| Voyage | Australia (1854-12-15) |
| Address in Australia | Carlton Road, Gawler East |
| Address State | South Australia |
| Time at address |
| Married | Widow | |
| Children | Yes | 4: 3 sons and 1 daughter, all in Gawler |
| Name of reference | William Henry Bay |
| Occupation of reference | Justice of the Peace (South Australia) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |