| Regimental number | 4041 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Manjimup, Western Australia |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, E Blanch, 748 Beaufort Street, Perth, Western Australia |
| Enlistment date | 7 September 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/28/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board RMS Mongolia on 22 November 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Motor Transport Section |
| Fate | Returned to Australia 21 June 1919 |
