| Occupation as written | Household duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 28 Oct 1909 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 2 Dec 1909 |
| If rejected, why? | |
| Birthplace as written | Klemzia, Zülchau, Germany |
| Modern country | Germany |
| Age on application | 70 |
| Age on arrival in Australia | 10 |
| Port of Departure | None |
| Port of Arrival | Adelaide |
| Date of arrival | 8 Jan 1850 |
| Name of ship | Emmy |
| Voyage | Emmie (1850-01-12) |
| Address in Australia | Anne Street, Stepney, Adelaide |
| Address State | South Australia |
| Time at address | 22 years |
| Previous address 1 | Burra |
| Address State | South Australia |
| Time at address | 10 years |
| Previous address 2 | Daveyston |
| Address State | South Australia |
| Time at address | 10 years |
| Previous address 3 | Rosenthal, South Australia, 4 years Rowland Flat, South Australia, 11 years Hakridge, 2 years |
| Address State | South Australia |
| Time at address |
| Married | Yes | |
| Children | Yes | 8: three males and five females, all in Adelaide. |
| Name of reference | George Henry Chou |
| 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 |