| Regimental number | 4103 |
| Religion | Church of England |
| Occupation | Soldier |
| Address | 2l8 Cowper Street, Waverley, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Mother, Mrs 0 Hansley, 218 Cowper Street, Waverley, New South Wales |
| Enlistment date | 4 October 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/21/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 30 December 1915 |
| Fate | No details of fate entered on Nominal Roll |
