| Regimental number | R1362 |
| Religion | Church of England |
| Occupation | Steel moulder |
| Address | Unley, South Australia |
| Marital status | Married |
| Age at embarkation | 24 |
| Next of kin | Wife, Mrs K M Sample C/o Mrs M A Bean, 19 Charles Street, Unley, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 23rd Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A35 Berrima on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Died of wounds |
| Miscellaneous details (Nominal Roll) | *Second entry both matched |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |