| Regimental number | ... |
| Religion | Church of England |
| Occupation | Accountant |
| Address | Bendigo, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs G A Shallard, 24 Charles Street, Footscray, Victoria |
| Enlistment date | |
| Rank on enlistment | Captain |
| Unit name | 14th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/31/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A28 Miltiades on |