| Regimental number | 4105 |
| Religion | Baptist |
| Occupation | Shipmate |
| Address | 11 Point Street, Pyrmont, New South Wales |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs. E. Nicol, Same address |
| Enlistment date | 10 September 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/20/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 30 December 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
