| Regimental number | 6621 |
| Place of birth | Adelaide, South Australia |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Klemzig, South Australia |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs C Ansell, Klemzig, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A16 Port Melbourne 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
