| Occupation as written | Domestic Duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 18 Aug 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 23 Aug 1911 |
| If rejected, why? | |
| Birthplace as written | Woladegaare, Denmark |
| Modern country | Denmark |
| Age on application | 55 |
| Age on arrival in Australia | 38 |
| Port of Departure | Hamburg |
| Port of Arrival | Sydney |
| Date of arrival | 15 Jul 1893 |
| Name of ship | Sommerfeldt |
| Voyage | Sommerfeldt (1893-07-15) |
| Address in Australia | Mullumbimby |
| Address State | New South Wales |
| Time at address | 13 years, 6 months |
| Previous address 1 | Lismore |
| Address State | New South Wales |
| Time at address | 6 months |
| Previous address 2 | Alstonville |
| Address State | New South Wales |
| Time at address | 4 years |
| Married | No |
| Children | No |
| Name of reference | Charles James Watts |
| Occupation of reference | Senior Constable of Police (New South Wales) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |