| Religion | Presbyterian |
| Occupation | Stockman |
| Address | c/o Peter Neilsen, Kangaroo Point, Brisbane, Queensland |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Johan Fairweather, c/o Peter Neilsen, Kangaroo Point, Brisbane, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Light Horse Regiment, 6th Reinforcement |
| AWM Embarkation Roll number | 10/16/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A47 Mashobra on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
