| Occupation as written | Home duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 31 May 1916 |
| Application status | Already a Subject |
| Official | LTF |
| Date of approval or denial | 20 Jun 1916 |
| If rejected, why? | |
| Birthplace as written | Pommerzig, Germany |
| Modern country | Poland |
| Age on application | 66 |
| Age on arrival in Australia | 16 |
| Port of Departure | Germany |
| Port of Arrival | Melbourne |
| Date of arrival | 1 Oct 1864 |
| Name of ship | Adelaide |
| Voyage | Adelaide (1964-10-01) |
| Address in Australia | Torrumbarry |
| Address State | Victoria |
| Time at address | 41 years |
| Previous address 1 | Geelong |
| Address State | Victoria |
| Time at address | 9 years |
| Married | Yes | |
| Children | Yes | 6 daughters |
| Name of reference | Andrew William Henry White |
| Occupation of reference | Justice of the Peace (Victoria) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | Buying land or mortgage |
| Other information | Something illegible involving The Colonial Bank of Australia Ltd |