| Regimental number | 6803 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Ingham, Queensland |
| Marital status | Single |
| Age at embarkation | 38 |
| Next of kin | Mother, Mrs E Sanders, 1 Charles Street, Exmouth Devon, England |
| Enlistment date | 5 May 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 23rd Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A35 Berrima on 23 December 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |