| Regimental number | 4104 |
| Place of birth | Sandford Victoria |
| Religion | Church of England |
| Occupation | Driver |
| Address | 145 Dover Street, Richmond, Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Hellen J Fordham, 145 dover Street, Richmond, Melbourne, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 24th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/41/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 24th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
