| Regimental number | 931a |
| Marital status | Single |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 4th Light Horse Regiment, 5th Reinforcement |
| AWM Embarkation Roll number | 10/9/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A56 Palermo on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |