| Regimental number | 3407 |
| Religion | Church of England |
| Occupation | Railway employee |
| Address | Casterton, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, C A McIntyre, Bonar Addison Street, Casterton, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/30/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A17 Port Lincoln on |