| Regimental number | 6737 |
| Place of birth | Lacross United States Of America |
| Religion | Roman Catholic |
| Occupation | Sailor |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mrs Eliza Nann, Wisconsin, USA |
| Enlistment date | |
| Rank on enlistment | Driver |
| Unit name | Army Service Corps 17, Reinforcement 1 |
| AWM Embarkation Roll number | 25/36/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A11 Ascanius on |
| Miscellaneous details (Nominal Roll) | nomnr |