| Regimental number | 4109 |
| Religion | Church of England |
| Occupation | Tailor |
| Address | 3 Edward Street, Elsternwick, Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Alice Lillian Foster, 3 Edward Street, Elsternwick, Melbourne, Victoria |
| Enlistment date | 17 January 1916 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/39/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on 7 March 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
