| Regimental number | 66758 |
| Place of birth | Wyndham New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Wyndham, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs M A Moore, Wyndham, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 22 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Wyreema on |
| Rank from Nominal Roll | Private |