| Regimental number | 3144 |
| Place of birth | Melbourne Victoria |
| Religion | Methodist |
| Occupation | Butcher |
| Address | c/o Mrs Broad, Millswyn Street, South Yarra, Victoria |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs E Jacobe, c/o Mrs Broad, Millswyn Street, South Yarra, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/23/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT RMS Osterley on |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 5th Battalion |
| Recommendations (Medals and Awards) |
Military Medal Recommendation date: |
| Fate | Returned to Australia |