| Occupation as written | No occupation |
| Standardised occupation | XX00: Other - Other |
| Application received | 21 Feb 1912 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 23 Feb 1912 |
| If rejected, why? | |
| Birthplace as written | Copenhagen, Denmark |
| Modern country | Denmark |
| Age on application | 27 |
| Age on arrival in Australia | 4 |
| Port of Departure | Copenhagen |
| Port of Arrival | Townsville |
| Date of arrival | 16 Jan 1888 |
| Name of ship | Jumma |
| Voyage | Jumna (1888-01-16) |
| Address in Australia | Phillipson Road, Charters Towers |
| Address State | Queensland |
| Time at address | 14 years |
| Previous address 1 | Ravenswood |
| Address State | Queensland |
| Time at address | 8 years |
| Previous address 2 | Hughenden |
| Address State | Queensland |
| Time at address | 2 years |
| Married | No |
| Children | No |
| Name of reference | Vernon Winstanley |
| 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 |