| Regimental number | 1306 |
| Place of birth | Northam, Western Australia |
| Religion | Church of England |
| Occupation | Labourer |
| Address | ... |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, W Blake, York Street, Northam, Western Australia |
| Enlistment date | 25 September 1914 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/28/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A50 Itonus on 22 February 1915 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 19 December 1918 |
