| Regimental number | 3754 |
| Place of birth | Ballarat Victoria |
| Religion | Church of England |
| Occupation | Draper |
| Address | Ballarat East, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, W McIntosh, 24 Queen Street, Ballarat East, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 58th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/75/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Ormonde on |
| Rank from Nominal Roll | Corporal |
| Fate | Returned to Australia |
| Miscellaneous details (Nominal Roll) | 58th Bn |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
