| Occupation as written | Home duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 20 Sep 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 25 Sep 1911 |
| If rejected, why? | |
| Birthplace as written | Basses Pyrennees, France |
| Modern country | France |
| Age on application | 37 |
| Age on arrival in Australia | 27 |
| Port of Departure | London |
| Port of Arrival | Melbourne |
| Date of arrival | 10 Apr 1907 |
| Name of ship | Ortona |
| Voyage | Ortona (1907-04-10) |
| Address in Australia | Cumming Street, Mile End |
| Address State | South Australia |
| Time at address |
| Previous address 1 | Melbourne |
| Address State | Victoria |
| Time at address | 3 years |
| Married | Yes | |
| Children | Yes | 1: female living with me |
| Name of reference | Henry Brunner |
| 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 |