| Occupation as written | Housekeeper |
| Standardised occupation | DS01: Domestic service - Indoor service |
| Application received | 17 Sep 1913 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 19 Sep 1913 |
| If rejected, why? | |
| Birthplace as written | Haynan, Schlesien, Prussia |
| Modern country | Poland |
| Age on application | 41 |
| Age on arrival in Australia | 3 |
| Port of Departure | Hamburg |
| Port of Arrival | Melbourne |
| Date of arrival | 22 Jan 1875 |
| Name of ship | Sommersetshire |
| Voyage | Somersetshire (1875-01-22) |
| Address in Australia | Culeairon |
| Address State | New South Wales |
| Time at address | 7 years |
| Previous address 1 | Temgamah |
| Address State | Victoria |
| Time at address | 31 years |
| Married | No |
| Children | No |
| Name of reference | William Arthur Stoyles |
| Occupation of reference | Justice of the Peace (New South Wales) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |