| Occupation as written | Domestic |
| Standardised occupation | DS01: Domestic service - Indoor service |
| Application received | 18 May 1917 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 13 Jun 1917 |
| If rejected, why? | |
| Birthplace as written | Stonnington, Connecticut, USA |
| Modern country | United States of America |
| Age on application | 49 |
| Age on arrival in Australia | 24 |
| Port of Departure | New York |
| Port of Arrival | Sydney |
| Date of arrival | 29 Oct 1891 |
| Name of ship | Carrie Winslaw |
| Voyage | Carrie Winslaw (1891-10-29) |
| Address in Australia | 46 Alexander St., Sydney |
| Address State | New South Wales |
| Time at address | 20 years |
| Previous address 1 | Waverley |
| Address State | New South Wales |
| Time at address | 5 years |
| Married | Widow |
| Children | No |
| Name of reference | Alfred Walker |
| Occupation of reference | Justice of the Peace (New South Wales) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |