| Regimental number | 1621 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o Mr Mills, Gorobimilla Siding near Narrandera, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Sister, E Jackson, The Homestead, East Preston Tooting, England |
| Enlistment date | 21 April 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 1st Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A32 Themistocles on 12 May 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
