| Occupation as written | House keeper |
| Standardised occupation | DS01: Domestic service - Indoor service |
| Application received | 3 Jul 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 4 Jul 1911 |
| If rejected, why? | |
| Birthplace as written | Thosstrops, Holbeck, Denmark |
| Modern country | Denmark |
| Age on application | 59 |
| Age on arrival in Australia | 19 |
| Port of Departure | Denmark |
| Port of Arrival | Maryborough |
| Date of arrival | 8 Aug 1871 |
| Name of ship | SS Shakespeare |
| Voyage | Shakespeare (1871-08-03) |
| Address in Australia | 12 Lincoln St., Perth |
| Address State | Western Australia |
| Time at address |
| Married | Widow | |
| Children | Yes | 3: 1 son in Mauritius, 2 daughters, one in Geralaton and 1 in Perth |
| Name of reference | Arthur Sunter |
| Occupation of reference | Corporal of Police, Western Australia |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |