| Regimental number | 6567 |
| Place of birth | Eulo Queensland |
| Religion | Church of England |
| Occupation | Station hand |
| Address | Hungerford, via Bourke, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs E Randall, Hungerford, via Bourke, New South Wales |
| Enlistment date | 23 May 1916 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/19/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 7 October 1916 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 3rd Australian Auxiliary Hospital |
| Fate | Effective abroad (still overseas) |
