| Regimental number | 3649 |
| Religion | Church of England |
| Occupation | Carter |
| Address | West Kogorah, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs Harriett Jeffries, Queen Victoria Street, West Kogorah, New South Wales |
| Previous military service | 38th Infantry |
| Enlistment date | 23 July 1917 |
| Rank on enlistment | Private |
| Unit name | 55th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/72/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 31 October 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
