| Regimental number | 1093 |
| Place of birth | Port Lincoln, South Australia |
| Religion | Church of England |
| Occupation | Boilermaker |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | A Black, Murray Bridge PO, Murray Bridge, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, B Company |
| AWM Embarkation Roll number | 23/30/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | a PROV C |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | West Terrace Cemetery |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
