| Regimental number | 630 |
| Place of birth | Brisbane Queensland |
| Religion | Church of England |
| Occupation | Commercial traveller |
| Address | c/o Mrs. Shayson, Norman Street, Wooloowin |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mrs. Lettie Lane, c/o Mrs. Shayson, Norman Street, Wooloowin |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 2nd Light Horse Regiment, 1st Reinforcement |
| AWM Embarkation Roll number | 10/7/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A42 Boorara on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Light Horse Regiment |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
