| Regimental number | 2795 |
| Place of birth | Toowoomba Queensland |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 'Geham', Toowoomba, Queensland |
| Marital status | Single |
| Age at embarkation | 44 |
| Next of kin | Mother, Mrs Mary Ann Black, 'Geham', Toowoomba, Queensland |
| Enlistment date | 18 August 1917 |
| Rank on enlistment | Private |
| Unit name | Australian Remount Unit 2, Reinforcement 5 |
| AWM Embarkation Roll number | 28/3/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A47 Mashobra on 5 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 18th Remounts |
| Fate | Returned to Australia 23 July 1919 |
