| Regimental number | 10807 |
| Place of birth | Port Wakefield, South Australia |
| Religion | Church of England |
| Occupation | Secretary |
| Address | Amateur Sports Club, Swanston Street, Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs E H Blackbourn, C/0 Cec Lucas, 413 Collins Street, Melbourne, Victoria |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 3rd Divisional Train, 22nd Company, Army Service Corps |
| AWM Embarkation Roll number | 25/16/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A34 Persic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Division Train |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
