| Occupation as written | domestic servant |
| Standardised occupation | DS01: Domestic service - Indoor service |
| Application received | 6 Mar 1912 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 11 Mar 1912 |
| If rejected, why? | |
| Birthplace as written | Nancy, Mourthe en Moselle, Alsace Lorraine |
| Modern country | France |
| Age on application | 49 |
| Age on arrival in Australia | 28 |
| Port of Departure | Blackwell, England |
| Port of Arrival | Brisbane |
| Date of arrival | 4 Jan 1891 |
| Name of ship | Steamer Tara |
| Voyage | Tara (1891-01-04) |
| Address in Australia | c/o Mr J. S. Cameron Lockiel, Toorsh Road, Hamilton, Brisbane |
| Address State | Queensland |
| Time at address |
| Previous address 1 | Bundaberg 1 yr, Ormiston 6 yrs, Brisbane 4 yrs |
| Address State | Queensland |
| Time at address | 11 years |
| Previous address 2 | Perth |
| Address State | Western Australia |
| Time at address | 8 years |
| Previous address 3 | Wagga Wagga |
| Address State | New South Wales |
| Time at address | 2 years |
| Married | No |
| Children | No |
| Name of reference | James Bray Lugg |
| Occupation of reference | Justice of the Peace (Queensland) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |