| Regimental number | 4968 |
| Religion | Church of England |
| Address | Kalgoorlie, Western Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Friend, 0 R Collins, National Hotel, Kalgoorlie, Western Australia |
| Enlistment date | 24 January 1916 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A38 Ulysses on 1 April 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |