| Regimental number | 1762 |
| Place of birth | Lawson New South Wales |
| Religion | Church of England |
| Occupation | Painter |
| Address | Tarrand Street, North Hill, Forbes, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs M Sams, Tarrand Street, North Hill, Forbes, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/36/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A61 Kanowna on |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 18th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
