| Occupation as written | Domestic Duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 18 Mar 1912 |
| Application status | Approved |
| Official | CSS |
| Date of approval or denial | 17 Apr 1912 |
| If rejected, why? | |
| Birthplace as written | Krossen, Prussia |
| Modern country | Poland |
| Age on application | 62 |
| Age on arrival in Australia | 5 |
| Port of Departure | Prussia |
| Port of Arrival | Port Adelaide |
| Date of arrival | 1 Jan 1853 |
| Name of ship | Laroschell |
| Voyage | La Rochelle |
| Address in Australia | Wodongo West |
| Address State | Victoria |
| Time at address |
| Married | Yes | |
| Children | Yes | 8: 6 females and 2 males. Wodonga |
| Name of reference | A L Wright |
| Occupation of reference | Justice of the Peace (Victoria) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |