| Regimental number | 69269 |
| Place of birth | Chiltern Victoria |
| Religion | Methodist |
| Occupation | Railway employee |
| Address | Chiltern Valley via Chiltern, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, A Guy, Chiltern Valley via Chiltern, Victoria |
| Enlistment date | 25 April 1918 |
| Rank on enlistment | Private |
| Unit name | 17th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 2 November 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
