| Occupation as written | Housekeeper |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 20 Aug 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 31 Aug 1911 |
| If rejected, why? | |
| Birthplace as written | Copenhagen, Denmark |
| Modern country | Denmark |
| Age on application | 63 |
| Age on arrival in Australia | 24 |
| Port of Departure | Copenhagen |
| Port of Arrival | Maryborough |
| Date of arrival | 1 Sep 1872 |
| Name of ship | SS Shakespeare |
| Voyage | Shakespeare (1872-10-01) |
| Address in Australia | East Lane (off Derby Street), Rockhampton |
| Address State | Queensland |
| Time at address |
| Previous address 1 | Sydney |
| Address State | New South Wales |
| Time at address |
| Previous address 2 | Maryborough |
| Address State | Queensland |
| Time at address |
| Previous address 3 | Bundaberg |
| Address State | Queensland |
| Time at address |
| Married | Widow | |
| Children | Yes | 3 living (1 son, 2 daughters) and 1 dead |
| Name of reference | Arthur Edgar Arkin |
| 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 |