| Regimental number | 5234 |
| Place of birth | Lismore New South Wales |
| Religion | Presbyterian |
| Occupation | Farmer |
| Address | Bundaberg, Queensland |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs. M.J. Black, Goodwin Street, Bundaberg, Queensland |
| Enlistment date | 26 July 1917 |
| Rank on enlistment | Private |
| Unit name | 31st Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/48/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Ormonde on 2 March 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 31st Battalion |
| Fate | Returned to Australia 5 January 1919 |
