| Regimental number | 6840 |
| Religion | Presbyterian |
| Occupation | Clerk |
| Address | Etna, Selbourne Street, Burwood, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs H C Van Epen, Etna, Selbourne Street, Burwood, Sydney, New South Wales |
| Enlistment date | 29 May 1916 |
| Date of enlistment from Nominal Roll | 29 April 1916 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/19/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Port Nicholson on 8 November 1916 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 2nd Battalion |
| Fate | Returned to Australia 8 July 1919 |