| Regimental number | 10586 |
| Religion | Church of England |
| Occupation | Steward |
| Address | Iona, Gippsland, Victoria |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Father, Charles Black, 'Hinemoa', Arden Street, Coogee North, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Driver |
| Unit name | Divisional Signal Company 3 |
| AWM Embarkation Roll number | 22/13/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 3rd Division Signal School |
| Fate | Discharged |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
