| Regimental number | 1405 |
| Place of birth | Rotterdam Holland |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | ... |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, F Rombouts, 53 Hugodogroot Street, Rotterdam, Holland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/33/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A46 Clan Mcgillivray on |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 11th Field Artillery Brigade |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
