| Regimental number | 3668 |
| Place of birth | Williams Town Victoria |
| Religion | Church of England |
| Occupation | Salesman |
| Address | Williamstown, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs M E Lake, 30 Twyford Street, Williamstown, Victoria |
| Enlistment date | 21 December 1917 |
| Rank on enlistment | Private |
| Unit name | 58th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/75/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Ormonde on 7 March 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 58th Battalion |
| Fate | Returned to Australia 8 July 1919 |
