| Regimental number | 1096 |
| Place of birth | Pretoria South Africa |
| Religion | Church of England |
| Occupation | Farmer |
| Address | c/o Mrs Evangeline Kotze, Angus Street, Ryde, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Evangeline Kotze, Angus Street, Ryde, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 12th Light Horse Regiment, 5th Reinforcement |
| AWM Embarkation Roll number | 10/17/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A32 Themistocles on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Light Horse Regiment |
| Fate | Returned to Australia |
| Miscellaneous information from cemetery records | Plaque in New South Wales Garden of Remembrance |
| Date of death |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
