| Regimental number | 4497 |
| Place of birth | Mudgee New South Wales |
| Religion | Church of England |
| Occupation | School teacher |
| Address | Wagga, New South Wales |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs Alice Blackman, Mooronga Station, Wagga, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | Australian Infantry Base Depot |
| Fate | Returned to Australia |
| Other details |
War service: Western Front |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
