| Occupation as written | House duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 12 Jan 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 13 Jan 1911 |
| If rejected, why? | |
| Birthplace as written | Lignitz, Silesia, Germany |
| Modern country | Poland |
| Age on application | 47 |
| Age on arrival in Australia | 17 |
| Port of Departure | Hamburg |
| Port of Arrival | Adelaide |
| Date of arrival | 1 Aug 1879 |
| Name of ship | Sofia |
| Voyage | Sophie (1879-08-28) |
| Address in Australia | Milner St. Richmond |
| Address State | South Australia |
| Time at address | 30 years |
| Married | Yes | |
| Children | Yes | 4: 2 boys and 2 girls living at Richmond |
| Name of reference | R P Blundell |
| 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 |