| Regimental number | 6109 |
| Place of birth | Wunghnu Victoria |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Wunghnu PO, Wunghnu, Victoria |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs Formby, Wunghnu PO, Wunghnu, Victoria |
| Enlistment date | |
| Rank on enlistment | Driver |
| Unit name | Infantry Brigade 5, 15th Company, Army Service Corps |
| AWM Embarkation Roll number | 25/103/1 |
| Embarkation details | Unit embarked from |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 4th Motor Transport Company |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
