| Regimental number | 630 |
| Religion | Methodist |
| Occupation | Stockman |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | H R Johnson, 29 Southcow Road, Woodside, South Norwood, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 1st Reinforcement |
| AWM Embarkation Roll number | 23/27/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT Themistocles on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |