| Regimental number | 5197 |
| Religion | Church of England |
| Occupation | Farmer |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mrs E Sansom, Yelverton, Devonshire, England |
| Enlistment date | |
| Rank on enlistment | Driver |
| Unit name | Light Horse Brigade Train 3 |
| AWM Embarkation Roll number | 25/100/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A51 Chilka on |
| Miscellaneous details (Nominal Roll) | see other |