| Regimental number | 62758 |
| Place of birth | West Midland Western Australia |
| Religion | Methodist |
| Occupation | Apprentice to car and waggon builder |
| Address | West Midland, Western Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Father, F Sampson, on active service; Mrs M Sampson, Harper Street, West Midland, Western Australia |
| Previous military service | 8th Battery Australian Field Artillery |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Western Australian Reinforcement 3 |
| AWM Embarkation Roll number | 23/111/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT Boonah 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
