| Regimental number | 4200 |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Company Street, Semaphore, South Australia |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs W Von Doussa, Company Street, Semaphore, South Australia |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A28 Miltiades on |
| Regimental number from Nominal Roll | 4290 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Machine Gun Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
