| Regimental number | 4650 |
| Religion | Roman Catholic |
| Occupation | Carpenter |
| Address | Jamberoo, via Kiama, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Cousin, Miss Bella Richardson, Jamberoo, via Kiama, New South Wales |
| Previous military service | 37th Infantry |
| Enlistment date | 14 November 1916 |
| 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 25 November 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |