| Regimental number | 65948 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Cook |
| Address | Muswellbrook, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs M Black, 25 Tait Street, Melbourne, Victoria |
| Enlistment date | 26 July 1918 |
| Rank on enlistment | Private |
| Unit name | 16th to 27th (NSW) Reinforcement |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A41 Bakara on 4 September 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Effective abroad (still overseas) |
