| Regimental number | 2004 |
| Religion | Protestant |
| Occupation | Labourer |
| Address | Ashley Street, North Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mrs Polly Phillips, Ashley Street, North Adelaide, South Australia |
| Enlistment date | 8 February 1915 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/27/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A20 Hororata on 20 April 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
