| Regimental number | 4138 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 182 Coventry Street, South Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, H Black, 182 Coventry Street, South Melbourne, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/23/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A64 Demosthenes on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Pioneer Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
