| Regimental number | 3012 |
| Religion | Roman Catholic |
| Occupation | Contractor |
| Address | Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Grandparent, Mrs Catherine Adam sen, 12 Ivey Street, West Perth, Western Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Light Horse Regiment, 22nd Reinforcement |
| AWM Embarkation Roll number | 10/15/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A41 Bakara on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
