| Regimental number | 7193 |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Subiaco, Western Australia |
| Marital status | Married |
| Age at embarkation | 39 |
| Next of kin | Wife, Mrs Cecilia Van Raalte, 12 Bagot Road, Subiaco, Western Australia |
| Enlistment date | 15 January 1916 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 24th Reinforcement |
| AWM Embarkation Roll number | 23/33/6 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A28 Miltiades on 29 January 1917 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 44th Battalion |
| Fate | Returned to Australia 10 December 1918 |