| Regimental number | 4962 |
| Religion | Methodist |
| Occupation | Labourer |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs King, Pleasant Bank, Sprent, Tasmania |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/29/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A70 Ballarat on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |