| Regimental number | 4764 |
| Place of birth | Lancashire England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o Mrs Clark, Womerah Cross Street, Double Bay, New South Wales |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Mother, Mrs L Robertson, Spark Hall, Stretton near Warrington, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | a Prov C |
| Fate | Discharged |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
