| Regimental number | 4512 |
| Place of birth | Glen Innes New South Wales |
| Religion | Church of England |
| Occupation | Railway officer |
| Address | 12 Tighe Street, Wickham, Newcastle, New South Wales |
| Marital status | Married |
| Age at embarkation | 24 |
| Next of kin | Wife, Mrs C M Haslam, 12 Tighe Street, Wickham, Newcastle, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A70 Ballarat on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 54th Battalion |
| Fate | Effective abroad (still overseas) |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
