| Regimental number | 1362 |
| Place of birth | Bath England |
| Religion | Church of England |
| Occupation | Miner |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Alice Hazeldene, 96 Wattle Lane, Bendigo, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/22/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A46 Clan Macgillivray on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Battalion |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Kangaroo Flat Cemetery, Victoria |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
