| Regimental number | 68868 |
| Place of birth | Carlton Victoria |
| Religion | Methodist |
| Occupation | Student |
| Address | Geelong, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs M C Surman, 86 Western Beach, Geelong, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 15th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A36 Boonah on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
