| Regimental number | 5634 |
| Place of birth | Kyneton Victoria |
| Religion | Roman Catholic |
| Occupation | Farm manager |
| Address | Kojunup, Western Australia |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs Edith Jane Mouritz, Richmond Street, Leederville, Western Australia |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A52 Surada on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | hqrs AIBD |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
