| Regimental number | 3338 |
| Occupation | Labourer |
| Address | ... |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | ..., No Relations |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A24 Benalla on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |