
| Regimental number | 87 |
| Place of birth | London England |
| Religion | Methodist |
| Occupation | Labourer |
| Address | 17 Herbert Street, Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs T R Sansom, 33 Wrentham Avenue, Brondesbury Park, London |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Australian Naval & Military Expeditionary Force (Queensland Reinforcement) |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |