| Regimental number | 10391 |
| Place of birth | Ballarat, Victoria |
| Religion | Church of England |
| Occupation | Driver |
| Address | 79 Pridham Street, Prahran, Victoria |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs G Bollen, 79 Pridham Street, Prahran, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade 4, Reinforcement 2 |
| AWM Embarkation Roll number | 13/32/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A19 Afric on |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 2nd Division Ammunition Column |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
