| Occupation as written | wife domestic duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 1 Jan 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 8 May 1911 |
| If rejected, why? | |
| Birthplace as written | Alt Christburg, East Prussia, Germany |
| Modern country | Poland |
| Age on application | 43 |
| Age on arrival in Australia | 16 |
| Port of Departure | Hamburg via London |
| Port of Arrival | Rockhampton |
| Date of arrival | 1 Jul 1883 |
| Name of ship | Duke of Westminster |
| Voyage | Duke of Westminster (1883-07-01) |
| Address in Australia | Hampden near Mackey |
| Address State | Queensland |
| Time at address | 23 years |
| Previous address 1 | Rockhampton |
| Address State | Queensland |
| Time at address | 4 years |
| Married | Yes | |
| Children | Yes | 7: 4 males and 3 females, all residing with me |
| Name of reference | James Vivian Bowen |
| 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 |