| Regimental number | 17458 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Croxton, Victoria |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Mary Phillips, 79 Gladstone Avenue, Croxton, Victoria |
| Enlistment date | 28 November 1916 |
| Rank on enlistment | Sapper |
| Unit name | |
| AWM Embarkation Roll number | 22/13/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A9 Shropshire on 11 May 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
