| Regimental number | 2110 |
| Place of birth | Geelong Victoria |
| Religion | Methodist |
| Occupation | Upholsterer |
| Address | c/o Mrs Rehenburg, Sparrowvale Farm, Geelong, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Guardian, Mrs Susan Chapman, c/o Mrs Rehenburg, Sparrowvale Farm, Geelong, Victoria |
| Enlistment date | 9 August 1915 |
| Rank on enlistment | Private |
| Unit name | 29th Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/46/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A70 Ballarat on 18 February 1916 |
| Miscellaneous details (Nominal Roll) | missing page |
