| Regimental number | 2200 |
| Religion | Presbyterian |
| Occupation | Farmer |
| Address | Ouyen, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, John Black, Ouyen, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 2nd Pioneer Battalion, Reinforcement 3 |
| AWM Embarkation Roll number | 14/14/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A62 Wandilla on |
| Fate | No details of fate entered on Nominal Roll |