| Regimental number | 5304 |
| Religion | Church of England |
| Occupation | Cycle mechanic |
| Address | c/o Mrs Lucy Paine, Myponga Terrace, Kilkenny, South Australia |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs Lucy Paine, Myponga Terrace, Kilkenny, South Australia |
| Enlistment date | 4 May 1915 |
| Rank on enlistment | Private |
| Unit name | |
| AWM Embarkation Roll number | 26/84/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A67 Orsova on 17 July 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
