| Regimental number | 3912 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Lake Babbine Hotel, Kulara, Queensland |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Sister, Mrs Sarah Neilsen, 5 Slake Terrace, Hartlepool, England |
| Enlistment date | 1 February 1917 |
| Rank on enlistment | Private |
| Unit name | 4th Pioneer Battalion, Reinforcement 10 |
| AWM Embarkation Roll number | 14/16/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on 13 June 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
