| Regimental number | 2130 |
| Place of birth | Mittagong New South Wales |
| Occupation | Labourer |
| Address | Dubbo, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, Samuel Lake, Darling Street, Dubbo, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | December 1916 Reinforcements |
| AWM Embarkation Roll number | 11/14/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Karmala on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Anzac Battalion, Imperial Camel Corps |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
