| Regimental number | 69370 |
| Place of birth | Ascotvale Victoria |
| Religion | Congregational |
| Occupation | Rubber mechanic |
| Address | 60 Aspen Street, Moonee Ponds, Victoria |
| Marital status | Married |
| Age at embarkation | 24 |
| Next of kin | Wife, Mrs A V Petherick, 60 Aspen Street, Moonee Ponds, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 17th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on |
| Unit from Nominal Roll | 17 GS REINFCTS |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
| Date of death | |
| Age at death from cemetery records | 25 |
| Place of burial | Quarantine Station (Plot unnumbered), North Head, Sydney |
| Panel number, Roll of Honour, Australian War Memorial | 185 |
| Miscellaneous information from cemetery records | Plaque in Garden of Remembrance, Victoria. Native of Ascot Vale, Victoria. Enlisted for Overseas Service. Husband of Mrs A HART (formerly PETHERICK) |