| Regimental number | 3902 |
| Place of birth | Middleborough England |
| Religion | Church of England |
| Occupation | Miner |
| Address | c/o Mr Thompson, Fimiston Road, boulder, Western Australia |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Father, S Poortvliet, Middleborough, Holland |
| Enlistment date | 27 July 1917 |
| Date of enlistment from Nominal Roll | 24 July 1917 |
| Rank on enlistment | Private |
| Unit name | 51st Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/68/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A60 Aeneas on 30 October 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | b Division Rein Wing |
| Fate | Returned to Australia 22 September 1919 |
