| Regimental number | 3646 |
| Religion | Methodist |
| Occupation | Shop assistant |
| Address | Queen Victoria Street, West Kogarah, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Harriet Jefferies, Queen Victoria Street, West Kogarah, New South Wales |
| Enlistment date | 9 July 1917 |
| Rank on enlistment | Private |
| Unit name | 53rd Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/70/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A28 Miltiades on 2 August 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
