| Regimental number | 68578 |
| Place of birth | Malmsbury Victoria |
| Religion | Church of England |
| Occupation | Commercial traveller |
| Address | 149 Primrose Street, Essendon, Victoria |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs J K Gully, 149 Primrose Street, Essendon, Victoria |
| Enlistment date | 20 April 1918 |
| Rank on enlistment | Private |
| Unit name | 14th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A36 Boonah on 22 October 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
