| Regimental number | 6773 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Driver |
| Address | North Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs Minnie Ballem, 112 Holden Street, North Fitzroy, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 23rd Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/40/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 23rd Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
