| Regimental number | 3572 |
| Religion | Church of England |
| Occupation | Miner |
| Address | Stockton, Newcastle, New South Wales |
| Marital status | Married |
| Age at embarkation | 40 |
| Next of kin | Wife, Mrs S Bloomfield, Maitland Street, Stockton, Newcastle, New South Wales |
| Enlistment date | 6 April 1916 |
| Rank on enlistment | Sapper |
| Unit name | |
| AWM Embarkation Roll number | 16/13/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A69 Warilda on 22 May 1916 |
| Miscellaneous details (Nominal Roll) | see other |
