| Occupation as written | Domestic duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 13 Sep 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 14 Sep 1911 |
| If rejected, why? | |
| Birthplace as written | Habendorf, Reichenbach, Germany |
| Modern country | Germany |
| Age on application | 59 |
| Age on arrival in Australia | 20 |
| Port of Departure | Germany |
| Port of Arrival | Adelaide |
| Date of arrival | 14 Oct 1872 |
| Name of ship | Helena |
| Voyage | Helene (1872-10-14) |
| Address in Australia | Parkside |
| Address State | South Australia |
| Time at address | 29 years |
| Previous address 1 | Adelaide |
| Address State | South Australia |
| Time at address | 6 years |
| Previous address 2 | Balaklava |
| Address State | South Australia |
| Time at address | 4 years |
| Married | Widow | |
| Children | Yes | 2: sons, on at Parkside and on at Plymouth |
| Name of reference | Arthur Frederick Pearson |
| Occupation of reference | Justice of the Peace (South Australia) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |