| Regimental number | 3445 |
| Place of birth | Tabulam, New South Wales |
| School | Lismore Superior Public School, New South Wales |
| Address | Murwillumbah, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, James Sampson, Byron Bay, New South Wales |
| Previous military service | Nil |
| Enlistment date | |
| Unit name | 15th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/32/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A48 Seang Bee on |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 15th Battalion |
| Fate | Died of disease |
| Miscellaneous details (Nominal Roll) | There is no entry on the Nominal Roll. These details are drawn from the Office War Graves records in order to complete the entry. |
| Place of death or wounding | Australia |
| Age at death | 24 |
| Place of burial | Bangalow Cemetery (Church of England Section), New South Wales |
| Miscellaneous information from cemetery records | Did not leave Australia with the Reinforcement. Died of the effects of meningitis and diptheria. |