| Regimental number | 2631 |
| Place of birth | Gin Gin Queensland |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Tirroan, Mount Perry Line |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Amy Bettiens, Tirroan, Mount Perry Line |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, C Company |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A49 Seang Choon on |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | a PROV C |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
