| Regimental number | 5875 |
| Place of birth | Hay New South Wales |
| Religion | Church of England |
| Occupation | Independent |
| Address | No fixed abode |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs Brenda Hope Percival, C/o Australian Bank of Commerce, 37 Threadneedle Street, London, England |
| Enlistment date | 6 September 1916 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/39/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A71 Nestor on 2 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Effective abroad (still overseas) |
