| Regimental number | 422 |
| Religion | Church of England |
| Occupation | Printer |
| Address | 2 Norman Street, Rozelle, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Aunt, Kate Nielson, 26 Mary Street, Surry Hills, Sydney, New South Wales |
| Enlistment date | 13 March 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, A Company |
| AWM Embarkation Roll number | 23/34/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board Transport A32 Themistocles on 12 May 1915 |
| Regimental number from Nominal Roll | Commissioned |
| Rank from Nominal Roll | Lieutenant |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 4 January 1919 |
| Miscellaneous details (Nominal Roll) | *given names on photocopy are Reginald Edward |