| Regimental number | 6839 |
| Religion | Church of England |
| Occupation | Station overseer |
| Address | North Merrowie, Hillston, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs C M Omerod, 4 Canterbury Road, Toorak, Victoria |
| Enlistment date | 30 July 1915 |
| Rank on enlistment | Driver |
| Unit name | Field Artillery Brigade 4, Battery 12 |
| AWM Embarkation Roll number | 13/32/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on 18 November 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
