| Regimental number | 2069 |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Derby, Tasmania |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs M Hines, Derby, Tasmania |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 15th Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/32/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A20 Hororata on |
| Fate | No details of fate entered on Nominal Roll |