| Occupation as written | house duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 1 Jan 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 17 Aug 1911 |
| If rejected, why? | |
| Birthplace as written | Grosslessen |
| Modern country | Germany |
| Age on application | 65 |
| Age on arrival in Australia | 11 |
| Port of Departure | Germany |
| Port of Arrival | Adelaide |
| Date of arrival | 1 Feb 1857 |
| Name of ship | Victoria |
| Voyage | Victoria (1857-02-14) |
| Address in Australia | Nurrootpa, Tanunda |
| Address State | South Australia |
| Time at address | 45 years |
| Previous address 1 | Moculla |
| Address State | South Australia |
| Time at address |
| Married | Widow | |
| Children | Yes | 9: 2 male and 7 female. 3 dead. |
| Name of reference | Benno Weidenbach |
| Occupation of reference | Justice of the Peace (South Australia) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | Pension |
| Other information | p.10, W. E. Heuzenroeder, Solicitor, Tanunda, 22 May 1911 - husband nat in S Austr and can't find proof to get Old Age Pension |