| Regimental number | 4730 |
| Place of birth | Brisbane Queensland |
| Religion | Church of England |
| Occupation | Bacon curer |
| Address | Holberton Street, Willowburn Toowoomba, Queensland |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, S Black, Russell Street, Toowoomba, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 9th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/26/4 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A73 Commonwealth on |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
