| Regimental number | 4980 |
| Place of birth | Tamworth New South Wales |
| Religion | Church of England |
| Occupation | Engineer's apprentice |
| Address | Waratah Street, Lithgow, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, J Blake, Waratah Street, Lithgow, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 33rd Battalion |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |