| Regimental number | 7428 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Broadmarsh, Tasmania |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Sister, Jane Holstom, Broadmarsh, Tasmania |
| Enlistment date | |
| Rank on enlistment | Sapper |
| Unit name | 8th Field Company Engineers, Reinforcement 5 |
| AWM Embarkation Roll number | 14/27/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT Star Of Victoria on |
| Fate | No details of fate entered on Nominal Roll |