| Regimental number | 13642 |
| Place of birth | Newcastle England |
| Religion | Methodist |
| Occupation | Warder |
| Address | Willowburn Hospital, near Toowomba, Queensland |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs M R Richardson, c/o Mrs H Clay, 'Fairview', Willowburn, Queensland |
| Enlistment date | 24 August 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Special Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on 29 March 1916 |