| Regimental number | 5109 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Seventeenth Street, The Lake Mildura, Victoria |
| Marital status | Married |
| Age at embarkation | 40 |
| Next of kin | Wife, Mrs R Humphries, Seventeenthstreet, The Lake Mildura, Victoria |
| Enlistment date | 17 January 1916 |
| Rank on enlistment | Private |
| Unit name | 7th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/24/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A23 Suffolk on 1 April 1916 |
| Fate | No details of fate entered on Nominal Roll |
