| Regimental number | 627 |
| Place of birth | Woodford Queensland |
| Religion | Church of England |
| Occupation | School teacher |
| Address | Lower Brunswick Street, New Farm, Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Mother, Mrs Lucinda Black, Lower Brunswick Street, New Farm, Brisbane, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 11, Reinforcement 10 |
| AWM Embarkation Roll number | 24/16/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A29 Suevic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 42nd Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
