| Regimental number | 500 |
| Place of birth | Peak Hill New South Wales |
| Religion | Roman Catholic |
| Occupation | Miner |
| Address | Caswell, Peak Hill, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mrs J A Hackett, Peak Hill, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion C Company |
| AWM Embarkation Roll number | 23/20/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
