| Occupation as written | Domestic servant |
| Standardised occupation | DS01: Domestic service - Indoor service |
| Application received | 16 Dec 1911 |
| Application status | Approved |
| Official | JAM |
| Date of approval or denial | 18 Dec 1911 |
| If rejected, why? | |
| Birthplace as written | Westervesede, Province of Hanover, Germany |
| Modern country | Germany |
| Age on application | 62 |
| Age on arrival in Australia | 17 |
| Port of Departure | Germany |
| Port of Arrival | Adelaide |
| Date of arrival | 6 May 1866 |
| Name of ship | Sophia |
| Voyage | Sophie (1866-08-24) |
| Address in Australia | Bethany, near Tanunda |
| Address State | South Australia |
| Time at address | 45 years |
| Married | No |
| Children | No |
| Name of reference | Freiderick Wilhelm Gussansky |
| 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 |