| Regimental number | 4123 |
| Place of birth | Ipswich England |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | J H Blake, 7 Gladstone, Road, Ipswich, Suffolk, England |
| Enlistment date | |
| Rank on enlistment | Gunner |
| Unit name | Divisional Ammunition Column 1, Reinforcement 4 |
| AWM Embarkation Roll number | 25/89/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A8 Argyllshire on |