| Regimental number | N/E |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Sussex, England |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | sister, Mrs Lilian Etheridge, 2 May Terrace, Shoreham, Sussex, England |
| Enlistment date | |
| Rank on enlistment | Sapper |
| Unit name | Mining Corps 1, Company 1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A38 Ulysses on |
| Fate | No details of fate entered on Nominal Roll |