| Regimental number | 17675 |
| Religion | Church of England |
| Occupation | Motor mechanic |
| Address | Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs Margaret Van Heythuysen, 'Le Oroha', 305 Addison Road, Marrickville, sydney, New South Wales |
| Enlistment date | 11 December 1916 |
| Rank on enlistment | Sapper |
| Unit name | 1st Field Squadron Engineers, March 1917 Reinforcements |
| AWM Embarkation Roll number | 14/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Port Sydney on 9 May 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 1st Field Squadron Engineers |
| Fate | Returned to Australia 26 August 1918 |
