| Regimental number | 17812 |
| Place of birth | Auckland New Zealand |
| Religion | Church of England |
| Occupation | Chemist |
| Address | Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs T M Peck, c/o Pike and Co, Insurance Manager, cr George and Jamison Streets, Sydney, New South Wales |
| Enlistment date | 8 January 1916 |
| Rank on enlistment | Staff Sergeant |
| Unit name | Staff Sergeant Dispensers |
| AWM Embarkation Roll number | 26/108/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A64 Demosthenes on 18 May 1916 |
| Rank from Nominal Roll | Staff Sergeant |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Effective abroad (still overseas) |
