| Regimental number | 69128 |
| Place of birth | Bendigo, Victoria |
| Religion | Church of England |
| Occupation | Builder |
| Address | 1 Murray Street, Prahran, Victoria |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs A M Blossett, 1 Murray Street, Prahran, Victoria |
| Enlistment date | 22 April 1918 |
| Rank on enlistment | Private |
| Unit name | 16th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Carpentaria on 7 November 1918 |
| Fate | No details of fate entered on Nominal Roll |
