| Regimental number | 479 |
| Religion | Church of England |
| Occupation | Traveller |
| Address | ... |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | ..., Mrs S A Metcalfe, 6 Weston Grove, Heaton Chapel near Manchester, England |
| Enlistment date | |
| Rank on enlistment | Lance Corporal |
| Unit name | 14th Battalion, D Company |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on |
| Rank from Nominal Roll | Lance Corporal |