| Regimental number | 5384 |
| Place of birth | Hague Holland |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Port Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Anna Mook, 100 Hosholredyk, Straat, Hague, Holland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 27th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/44/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A70 Ballarat on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Division Train |
| Fate | Effective abroad (still overseas) |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
