| Regimental number | 67921 |
| Place of birth | O'connell New South Wales |
| Religion | Church of England |
| Occupation | Agent |
| Address | 128 William Street, Bathurst, New South Wales |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Uncle, C Boyd, Rainham, Bathurst, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 27 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on |