| Occupation as written | Domestic duties |
| Standardised occupation | DS00: Domestic service - Domestic duties |
| Application received | 1 Jan 1917 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 15 Mar 1917 |
| If rejected, why? | |
| Birthplace as written | Moonambel, Avoca District, Victoria |
| Modern country | Australia |
| Age on application | 54 |
| Age on arrival in Australia | None |
| Port of Departure | None |
| Port of Arrival | None |
| Date of arrival | None |
| Name of ship | None |
| Address in Australia | 87 Russlyn Street |
| Address State | Victoria |
| Time at address |
| Married | Widow | |
| Children | Yes | 14: 9 boys, five daughters, 8 living in Victoria |
| Name of reference | Mathias Michael Perl |
| Occupation of reference | Justice of the Peace, Victoria |
| Marginalia description | Recd. 21/2/17 Husband un-naturalized. Husband of a Russian Finn. |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | other |
| Other information | renaturalisation. |
Husband was a Russian Finn.