| Regimental number | 53567 |
| Place of birth | Macquarie Plains Tasmania |
| Religion | Church of England |
| Occupation | Driver |
| Address | Auburn, New South Wales |
| Marital status | Married |
| Age at embarkation | 33 |
| Next of kin | Wife, Mrs V M Tillack, Park Road, Auburn, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 3 |
| AWM Embarkation Roll number | 23/111/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Division Train |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Eastern Suburbs Memorial Park Cemetery |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
