| Occupation as written | Nil, I am a widow without occupation |
| Standardised occupation | XX00: Other - Other |
| Application received | 2 Jun 1909 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 15 Jul 1909 |
| If rejected, why? | |
| Birthplace as written | Uslar, Kingdom of Hanover |
| Modern country | Germany |
| Age on application | 66 |
| Age on arrival in Australia | 21 |
| Port of Departure | Germany |
| Port of Arrival | Melbourne, Victoria |
| Date of arrival | 28 Jul 1864 |
| Name of ship | SS Great Britain |
| Voyage | Great Britain (1864-07-28) |
| Address in Australia | Kingower |
| Address State | Victoria |
| Time at address | 45 years |
| Married | Yes | |
| Children | Yes | 9: six boys and three girls |
| Name of reference | Thomas Henry White |
| Occupation of reference | Head Teacher of State School, Victoria |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |