| Occupation as written | Household duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 10 Sep 1914 |
| Application status | Already a Subject |
| Official | A.H. |
| Date of approval or denial | 15 Oct 1914 |
| If rejected, why? | |
| Birthplace as written | Magdeburgh, Germany |
| Modern country | Germany |
| Age on application | 63 |
| Age on arrival in Australia | 7 |
| Port of Departure | Magdeburgh, Germany |
| Port of Arrival | Port Adelaide |
| Date of arrival | 1 Sep 1858 |
| Name of ship | None |
| Address in Australia | Peterborough |
| Address State | South Australia |
| Time at address | 33 years |
| Previous address 1 | Tanunda |
| Address State | South Australia |
| Time at address | 22 years |
| Previous address 2 | Gladstone |
| Address State | Queensland |
| Time at address | 1 years |
| Married | Widow | |
| Children | Yes | 3: 1 female and 2 males |
| Name of reference | Robert Walter Goudis |
| Occupation of reference | Justice of the Peace (South Australia) |
| Marginalia description | p.1 'Ger' |
| Police report attached | Yes |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |