| Regimental number | 96 |
| Place of birth | Smethwick England |
| Religion | Church of England |
| Occupation | Carter |
| Address | ... |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | J Roberts, 44 Ada Road, Smethwick Stafordshire, England |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, A Company |
| AWM Embarkation Roll number | 23/28/1 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A7 Medic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
