| Occupation as written | Not any |
| Standardised occupation | XX00: Other - Other |
| Application received | 26 Aug 1909 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 24 Sep 1909 |
| If rejected, why? | |
| Birthplace as written | Werben, Germany |
| Modern country | Germany |
| Age on application | 80 |
| Age on arrival in Australia | 23 |
| Port of Departure | Werben, Germany |
| Port of Arrival | Port Adelaide, South Australia |
| Date of arrival | 1 Jan 1853 |
| Name of ship | Caesar Gottefrau |
| Voyage | Caesar Godeffroy (1853-01-01) |
| Address in Australia | Wasleys |
| Address State | South Australia |
| Time at address | 44 years |
| Previous address 1 | Mount Crawford |
| Address State | South Australia |
| Time at address | 10 years |
| Previous address 2 | Klemzig |
| Address State | South Australia |
| Time at address | 2 years |
| Married | Widow | |
| Children | Yes | 2 sons, 1 daughter |
| Name of reference | William Henry George |
| 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 |