| Regimental number | 805 |
| Religion | Presbyterian |
| Occupation | Carpenter |
| Address | PO 492, Pretoria, South Africa |
| Marital status | Single |
| Age at embarkation | 36 |
| Height | 6' 2" |
| Next of kin | Mother, Mrs E.I. Van Derwe, as above |
| Previous military service | Nil |
| Enlistment date | |
| Place of enlistment | Liverpool, New South Wales |
| Rank on enlistment | Private |
| Unit name | 7th Light Horse Regiment, 3rd Reinforcement |
| AWM Embarkation Roll number | 10/12/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A1 Hymettus on |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 1st Divisional Ammunition Column |
| Fate | Returned to Australia |
| Discharge date | |
| Other details |
Commenced return to Australia on board HT 'Malta', 31 July 1918; disembarked Melbourne, 28 September 1918, for onward travel to Sydney; discharged, Sydney, 24 May 1919. Medals: 1914-15 Star, British War Medal, Victory Medal |