| Regimental number | 69 |
| Religion | Church of England |
| Occupation | Miner |
| Address | Cloncurry, Queensland |
| Marital status | Single |
| Age at embarkation | 35 |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Australian Naval & Military Expeditionary Force (Queensland Reinforcement) |