| Regimental number | 67402 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Ironmoulder |
| Address | 40 John Street, Erskineville, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, W Jenner, 40 John Street, Erskineville, New South Wales |
| Previous military service | 2nd Battalion 55th Infantry |
| Enlistment date | 27 July 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 25 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Carpentaria on 7 November 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
