| Regimental number | 3109 |
| Place of birth | Dinham England |
| Religion | Church of England |
| Occupation | Seaman |
| Address | 184 Pines Street, Churchill, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs C Jacques, 5 Prissick Street, East Hartlepool, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 18th Battalion, 7th Reinforcement |
| AWM Embarkation Roll number | 23/35/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A29 Suevic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
