| Regimental number | 4399 |
| Place of birth | Warren New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Petersham, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs Mary Agnes Rose, 'Surrey', 12 Hampstead Road, Petersham, Sydney, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Port Napier on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
