| Regimental number | 3704 |
| Place of birth | Gelderland Netherlands |
| Religion | Protestant |
| Occupation | Gardener |
| Address | Mount Barker, South Australia |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Friend, W R Perers, Mount Barker, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/27/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board RMS Malwa on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
