| Occupation as written | domestic duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 17 Jan 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 18 Jan 1911 |
| If rejected, why? | |
| Birthplace as written | Greisheim, Baden, Germany |
| Modern country | Germany |
| Age on application | 62 |
| Age on arrival in Australia | 4 |
| Port of Departure | Hamburg |
| Port of Arrival | Melbourne |
| Date of arrival | 1 Jan 1853 |
| Name of ship | Robert Godefroy |
| Voyage | Robert Godefroy (1853-01-01) |
| Address in Australia | Clunes |
| Address State | Victoria |
| Time at address | 55 years |
| Previous address 1 | Creswick |
| Address State | Victoria |
| Time at address | 3 years |
| Married | Widow | |
| Children | Yes | 5: 4 boys and 1 girl |
| Name of reference | Frederick John Matthew |
| Occupation of reference | Justice of the Peace (Victoria) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |