| Occupation as written | Domestic Duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 1 Oct 1912 |
| Application status | Approved |
| Official | LTF |
| Date of approval or denial | 29 Oct 1912 |
| If rejected, why? | |
| Birthplace as written | Dahma, Schleisen, Germany |
| Modern country | Poland |
| Age on application | 76 |
| Age on arrival in Australia | 24 |
| Port of Departure | Germany |
| Port of Arrival | Port Adelaide |
| Date of arrival | 25 Aug 1859 |
| Name of ship | Alfred |
| Voyage | Alfred (1859-09-20) |
| Address in Australia | Hebbard Street, Broken Hill South |
| Address State | New South Wales |
| Time at address | 7 years |
| Previous address 1 | Buttermilk Station, Dawson |
| Address State | South Australia |
| Time at address |
| Previous address 2 | Burra |
| Address State | South Australia |
| Time at address |
| Married | Widow | |
| Children | Yes | 6 sons |
| Name of reference | William John Ritallick |
| 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 |