| Regimental number | 4620 |
| Place of birth | Bendigo Victoria |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Osborne Street, Bendigo, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, P Van, Osborne Street, Bendigo, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/23/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A32 Themistocles on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
