| Regimental number | 12661 |
| Place of birth | Glanville South Australia |
| Religion | Church of England |
| Occupation | Porter, S A R |
| Address | 7 McLaren Street, Adelaide, South Australia |
| Marital status | Married |
| Age at embarkation | 23 |
| Next of kin | Wife, Mrs H G Pearce, 7 McLaren Street, Adelaide, South Australia |
| Enlistment date | 2 January 1916 |
| Date of enlistment from Nominal Roll | 21 January 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Field Ambulance |
| AWM Embarkation Roll number | 26/54/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A29 Suevic on 31 May 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Field Ambulance |
| Fate | Effective abroad (still overseas) |
