| Occupation as written | Housewife |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 14 Aug 1912 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 26 Aug 1912 |
| If rejected, why? | |
| Birthplace as written | Schluckenam, Kingdom of Bohemia, Austria |
| Modern country | Czechia |
| Age on application | 44 |
| Age on arrival in Australia | 19 |
| Port of Departure | None |
| Port of Arrival | Melbourne |
| Date of arrival | 13 Aug 1887 |
| Name of ship | Nurnberg |
| Voyage | Nurnberg (1887-08-13) |
| Address in Australia | Watheroo |
| Address State | Western Australia |
| Time at address |
| Previous address 1 | Tasmania |
| Address State | Tasmania |
| Time at address | 1 years, 6 months |
| Previous address 2 | Melbourne |
| Address State | Victoria |
| Time at address | 6 years |
| Previous address 3 | Broken Hill, New South Wales - 10 months Freemantle and Perth, Western Australia - over 15 years |
| Address State | |
| Time at address |
| Married | Yes | |
| Children | Yes | 2: a girl in Perth, and a son in Meekatharra, Western Australia |
| Name of reference | John Alhis |
| Occupation of reference | Police Constable, Western Australia |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |