| Regimental number | 430 |
| Place of birth | Carisbrook, Victoria |
| Religion | Roman Catholic |
| Occupation | Fireman |
| Address | Traralgon, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, W Black, Wonthaggi, Victoria |
| Enlistment date | 20 December 1916 |
| Rank on enlistment | Private |
| Unit name | Railway Unit, Section 2 |
| AWM Embarkation Roll number | 15/9/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A70 Ballarat on 19 February 1917 |
| Rank from Nominal Roll | 2nd Corporal |
| Unit from Nominal Roll | 1st Railway Company |
| Fate | Returned to Australia 21 June 1919 |
