| Regimental number | 403 |
| Place of birth | Ararat, Victoria |
| Religion | Church of England |
| Occupation | Miner |
| Address | Ararat, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Louisa Blake, Moore Street, Ararat, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 39th Battalion, B Company |
| AWM Embarkation Roll number | 23/56/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
