| Occupation as written | Housewife |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 21 Aug 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 23 Aug 1911 |
| If rejected, why? | |
| Birthplace as written | Bringen on the Rhine, Germany |
| Modern country | Germany |
| Age on application | 61 |
| Age on arrival in Australia | 13 |
| Port of Departure | Benun on Byane |
| Port of Arrival | Brisbane |
| Date of arrival | 1 Apr 1863 |
| Name of ship | Benun Leeser Godea |
| Voyage | Benun Leeser Godea (1863-04-01) |
| Address in Australia | Bridge St West Townsville |
| Address State | Queensland |
| Time at address | 7 years |
| Previous address 1 | Stanthorpe |
| Address State | Queensland |
| Time at address | 23 years |
| Previous address 2 | Bona |
| Address State | Victoria |
| Time at address | 2 years |
| Previous address 3 | Crows Nest |
| Address State | New South Wales |
| Time at address | 14 years |
| Married | Widow | |
| Children | Yes | 7 |
| Name of reference | John William de Gruchy |
| Occupation of reference | Justice of the Peace (Queensland) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | N/A |
| Other information |