| Regimental number | 1004A |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Macknade, Herbert River, Queensland |
| Marital status | Single |
| Age at embarkation | 36 |
| Next of kin | Friend, Fred Bowen, manager, Washington and Soul Ltd., Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Light Horse Regiment, 4th Reinforcement |
| AWM Embarkation Roll number | 10/16/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A1 Hymettus on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
