| Regimental number | 3841 |
| Place of birth | Scarsdale Victoria |
| Religion | Church of England |
| Occupation | Mainer |
| Address | Scarsdale, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Carolina Black, Scarsdale, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 14th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/31/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on |
| Regimental number from Nominal Roll | 3841A |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 11th Field Artillery Brigade |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
