| Regimental number | 1402 |
| Religion | Church of England |
| Occupation | Engine-driver |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Mother, Mrs. Ellen Ann Green, Wainta P.O., South Island, New Zealand |
| Enlistment date | 14 July 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Light Horse Regiment, 11th Reinforcement |
| AWM Embarkation Roll number | 10/8/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A24 Benalla on 27 October 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
