| Regimental number | 6125 |
| Religion | Methodist |
| Occupation | Dairy hand |
| Address | Chisold Street, Katoomba, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mary May Souz, Station Street, Katoomba, New South Wales |
| Enlistment date | 28 June 1916 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A11 Ascanius on 25 October 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |