| Regimental number | 13041 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | 35 Iris Street, Paddington, New South Wales |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs C Hislop, 35 Iris Street, Paddington, New South Wales |
| Previous military service | 25th Infantry |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Gunner |
| Unit name | Divisional Ammunition Column 2, Reinforcement 4 |
| AWM Embarkation Roll number | 25/90/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 6th Field Artillery Brigade |
| Recommendations (Medals and Awards) |
Military Medal Recommendation date: |
| Fate | Returned to Australia |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 115 Date: |