| Religion | Baptist |
| Occupation | Tiler |
| Address | 174 Chandos Street, North Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs Hannah Medina, c/o L Carter, Gordon Road, Gordon Hill, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on |