| Regimental number | 4369 |
| Place of birth | Coopers Creek, Victoria |
| Religion | Church of England |
| Occupation | Gardener |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs Mary Ann Black, Coopers Creek, Gippsland, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/38/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Orontes on |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | AIF Headquarters |
| Fate | Effective abroad (still overseas) |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
