| Regimental number | 6915 |
| Religion | Church of England |
| Occupation | Packer |
| Address | Chelsea, Victoria |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs Mary Rose Van Lawick, 'Kinlock', Station Road, Chelsea, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/39/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
