| Regimental number | 62677 |
| Place of birth | Paterswolde Holland |
| Religion | Church of England |
| Occupation | Sailor |
| Address | Tanunda, South Australia |
| Marital status | Married |
| Age at embarkation | 27 |
| Next of kin | Wife, Mrs E S Rutgers, Tanunda, South Australia |
| Enlistment date | 31 August 1918 |
| Rank on enlistment | Private |
| Unit name | 6th General Service Reinforcements |
| AWM Embarkation Roll number | 23/111/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A36 Boonah on 22 October 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
| Other details | Medal: British War Medal |