| Occupation as written | no occupation |
| Standardised occupation | XX00: Other - Other |
| Application received | 4 Jul 1917 |
| Application status | Approved |
| Official | EC |
| Date of approval or denial | 18 Jul 1917 |
| If rejected, why? | |
| Birthplace as written | Killia, Russia (Hebrew) |
| Modern country | Russia |
| Age on application | 72 |
| Age on arrival in Australia | 56 |
| Port of Departure | Romumania |
| Port of Arrival | Melbourne |
| Date of arrival | 30 Aug 1900 |
| Name of ship | Orizaba |
| Voyage | Orizaba (1900-08-30) |
| Address in Australia | 192 Queensberry Street, Carlton |
| Address State | Victoria |
| Time at address |
| Married | Widow | |
| Children | Yes | 6: 1 Hathorn, 1 King St., the rest in Roumania |
| Name of reference | Thomas Henry Haigh |
| Occupation of reference | Police Constable (Victoria) |
| Marginalia description | p.1 F |
| Police report attached | No |
| Link to other applicant | |
| Literate | No |
| Reason | N/A |
| Other information |