| Regimental number | 8656 |
| Religion | Church of England |
| Address | 'Hardwick', 58 Jolimont Street, Jolimont, Victoria |
| Marital status | Single |
| Age at embarkation | 49 |
| Next of kin | Friend, Miss K Clark, 16 Belgrave Terrace, Grimsby, Lincolnshire, England |
| Enlistment date | |
| Rank on enlistment | 2nd Lieutenant |
| Unit name | Depot Unit Of Supply 5 |
| AWM Embarkation Roll number | 25/107/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on |
| Rank from Nominal Roll | Lieutenant |
| Unit from Nominal Roll | 5th Depot Unit of Supply |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
