| Regimental number | 30 |
| Place of birth | Port Melbourne Victoria |
| Religion | Church of England |
| Occupation | Contractor |
| Address | 277 Bay Street, Port Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, John H.P. Micah, 277 Bay Street, Port Melbourne, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 4th Light Horse Regiment, Headquarters |
| AWM Embarkation Roll number | 10/9/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board Transport A18 Wiltshire on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Light Horse Regiment |
| Fate | Returned to Australia |
| Miscellaneous details (Nominal Roll) | *Noted Bertie Lewis NR |
| Miscellaneous information from cemetery records | Plaque in Victorian Garden of Remembrance |
| Date of death |