| Regimental number | 6069 |
| Place of birth | Dunmow England |
| Religion | Church of England |
| Occupation | Tram conductor |
| Address | St Peters, South Australia |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs C F Hazelton, Hackney House, Hackney Road, St Peters, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A70 Ballarat on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
