| Regimental number | 3012 |
| Place of birth | Dubbo New South Wales |
| Religion | Church of England |
| Occupation | Shunter |
| Address | Gibbs Street, Dubbo, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs E A Moore, c/o E C Wake, Talbragar Estate via Dubbo, New South Wales |
| Enlistment date | 27 July 1917 |
| Date of enlistment from Nominal Roll | 27 November 1917 |
| Rank on enlistment | Private |
| Unit name | April 1918 Reinforcements |
| AWM Embarkation Roll number | 15/9/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A30 Borda on 17 July 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | raily Coys |
| Fate | Returned to Australia 15 January 1919 |