| Regimental number | 1811 |
| Place of birth | Warrnambool Victoria |
| Religion | Church of England |
| Occupation | Mechanic |
| Address | Park Street, Parkville, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, K. Sansom, Park Street, Parkville, Victoria |
| Enlistment date | 23 June 1915 |
| Rank on enlistment | Sapper |
| Unit name | Signal Company Engineers Reinforcement 12 |
| AWM Embarkation Roll number | 22/11/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A62 Wandilla on 9 November 1915 |
| Regimental number from Nominal Roll | Comissioned |
| Rank from Nominal Roll | Lieutenant |
| Unit from Nominal Roll | Australian Flying Corps |
| Fate | nig No details enetered on Nominal |
