| Regimental number | 11165 |
| Place of birth | Kent, England |
| Religion | Church of England |
| Occupation | Motor driver |
| Address | Annerley Road, South Brisbane, Queensland |
| Marital status | Married |
| Age at embarkation | 20 |
| Next of kin | Wife, Mrs E E Johnson, 11 Daleview, Buxton, Derbyshire, England |
| Enlistment date | 5 August 1915 |
| Place of enlistment | Enoggera, Queensland |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade 3, Reinforcement 14 |
| AWM Embarkation Roll number | 13/31/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 15 January 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | Australian Flying Corps |
| Fate | Effective abroad (still overseas) |
