| Regimental number | 2212 |
| Place of birth | Melbourne Victoria |
| Religion | Methodist |
| Occupation | Market gardener |
| Address | Bayview Road, Burwood, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Annie Ellen Moore, Bayview Road, Burwood, Victoria |
| Enlistment date | 19 April 1916 |
| Rank on enlistment | Private |
| Unit name | 58th Battalion, 4th Reinforcement |
| AWM Embarkation Roll number | 23/75/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A67 Orsova on 1 August 1916 |
| Rank from Nominal Roll | Private |
