| Regimental number | 67353 |
| Place of birth | London, England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 4 Bunn Street, Pyrmont, New South Wales |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs C Bastian, 6 Kerry Street, Tidal Basin, London, England |
| Enlistment date | 23 September 1918 |
| Place of enlistment | Sydney, New South Wales |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 25 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Carpentaria on 7 November 1918 |
| Fate | No details of fate entered on Nominal Roll |
