| Regimental number | 1892 |
| Place of birth | Bendigo Victoria |
| Religion | Roman Catholic |
| Occupation | Blacksmith |
| Address | Osborne Street, Bendigo, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, Peter Van, Osborne Street, Bendigo, Victoria |
| Previous military service | 67th Infantry |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 8th Light Horse Regiment, 13th Reinforcement |
| AWM Embarkation Roll number | 10/13/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A44 Vestalia on |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 11th Field Artillery Brigade |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
