| Occupation as written | Gentlewoman |
| Standardised occupation | XX00: Other - Other |
| Application received | 1 Sep 1909 |
| Application status | Approved |
| Official | |
| Date of approval or denial | 24 Sep 1909 |
| If rejected, why? | |
| Birthplace as written | Woldenberg, Prussia, Germany |
| Modern country | Germany |
| Age on application | 64 |
| Age on arrival in Australia | 12 |
| Port of Departure | Germany |
| Port of Arrival | Melbourne, Victoria |
| Date of arrival | 20 Oct 1857 |
| Name of ship | SS Henry |
| Voyage | Henry (1857-10-20) |
| Address in Australia | Donald |
| Address State | Victoria |
| Time at address |
| Previous address 1 | Talbot |
| Address State | Victoria |
| Time at address | 34 years |
| Previous address 2 | Majorca |
| Address State | Victoria |
| Time at address | 6 years |
| Previous address 3 | Inglewood, Victoria, 4 years Claywood, Victoria, 1 year |
| Address State | Victoria |
| Time at address |
| Married | Widow | |
| Children | Yes | 2: Tailor, and Amelia Agnes Ohilia Wardley wife of John Wardley of Donald, Victoria. |
| Name of reference | Henry Widdop |
| Occupation of reference | Justice of the Peace (Victoria) |
| Marginalia description | |
| Police report attached | No |
| Link to other applicant | |
| Literate | Yes |
| Reason | N/A |
| Other information |