| Regimental number | 240 |
| Occupation | Farmer |
| Address | Roughhead Street, Leongatha, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs Mary Collis, Roughhead Street, Leongatha, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 6, Reinforcement 2 |
| AWM Embarkation Roll number | 24/11/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A17 Port Lincoln on |
| Fate | No details of fate entered on Nominal Roll |