| Regimental number | 5340 |
| Place of birth | Fitzroy Victoria |
| Religion | Church of England |
| Occupation | Farm hand |
| Address | West Leederville, Western Australia |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs L Jessup, Cambridge Street, West Leederville, Western Australia |
| Enlistment date | 11 June 1915 |
| Rank on enlistment | Private |
| Unit name | Convalescent Depot, Harefield Park, London |
| AWM Embarkation Roll number | 26/84/1 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A67 Orsova on 22 July 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Field Ambulance |
| Fate | Effective abroad (still overseas) |
