| Regimental number | 2625 |
| Place of birth | Junee New South Wales |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Wantiool via Junee, New South Wales |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs Sarah Jane Phillips, Wantioolvia Junee, New South Wales |
| Enlistment date | 15 April 1917 |
| Rank on enlistment | Private |
| Unit name | 12th Light Horse Regiment, 23rd Reinforcement |
| AWM Embarkation Roll number | 10/17/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Canberra on 16 November 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
