| Regimental number | 69103 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Butcher |
| Address | Oakleigh Road, Murrumbeena, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, A E Rose, Oakleigh Road, Murrumbeena, Victoria |
| Enlistment date | 20 June 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 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
