| Regimental number | 53780 |
| Place of birth | Grafton New South Wales |
| Religion | Roman Catholic |
| Occupation | Carrier |
| Address | Cootamundra, New South Wales |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Friend, Madam Kathleen Lora Mussen, 'Clarence', Cooper Street, Cootamundra, New South Wales |
| Enlistment date | 18 March 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 4 |
| AWM Embarkation Roll number | 23/111/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Feldmarschall on 19 June 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th General Service Reinforcements |
| Fate | Effective abroad (still overseas) |
