| Regimental number | 1714 |
| Religion | Church of Christ |
| Occupation | Labourer |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Mrs E A Holly High Street, Ashburton, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/38/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A64 Demosthenes on |
| Fate | No details of fate entered on Nominal Roll |