| Regimental number | 5031 |
| Place of birth | Bathurst New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o Mrs C Fern, Camden, New South Wales |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Sister, Mrs R Fern, Camden, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 54th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
