| Regimental number | 5255 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Laster |
| Address | 132 Rupert Street, Collingwood, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, W Black, 132 Rupert Street, Collingwood, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 14th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/31/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A68 Anchises on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 60th Battalion |
| Place of burial | Grevillers British Cemetery (Plot XVIII, Row C, Grave No. 16), France |
| Panel number, Roll of Honour, Australian War Memorial | 170 |
| Miscellaneous information from cemetery records | See "MILES", the true family name |