| Regimental number | 57864 |
| Place of birth | Stoke on Trent, England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o Mr Pedlar, Ipswich Road, South Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Legatee, Jno Wilson, c/o Mr Pedlar, Ipswich Road, South Brisbane, Queensland |
| Enlistment date | 8 June 1918 |
| Place of enlistment | Brisbane, Queensland |
| Rank on enlistment | Private |
| Unit name | Queensland Reinforcement 5 |
| AWM Embarkation Roll number | 23/111/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A30 Borda on 17 July 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 15th Battalion |
| Fate | Effective abroad (still overseas) |
