| Regimental number | 876 |
| Place of birth | Essex England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o C C Johnson, Newnham, Baldock, Herts, England |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | C C Johnson, Newnham, Baldock, Herts, England |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, 4th Reinforcement |
| AWM Embarkation Roll number | 10/10/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A15 Star of England on |
| Embarkation details | Unit embarked from |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 5th Light Horse Regiment |
| Recommendations (Medals and Awards) |
Military Medal Letter/List 16 November 21. Recommendation date: |
| Fate | Returned to Australia |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 120 Date: |