| Regimental number | 780 |
| Place of birth | Tattershall England |
| Religion | Church of England |
| Occupation | Storeman |
| Address | ... |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs J Hubbert, Tattershall, Lincolnshire, England |
| Enlistment date | 24 September 1914 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 1st Reinforcement |
| AWM Embarkation Roll number | 23/33/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A35 Berrima on 22 December 1914 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia 23 October 1918 |
