| Regimental number | 4000 |
| Place of birth | Secunderabad India |
| Religion | Church of England |
| Occupation | Contractor |
| Address | Surry Hills, New South Wales |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Aunt, N Thomas, 141 Albion Street, Surry Hills, New South Wales |
| Enlistment date | 9 August 1915 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/30/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A29 Suevic on 20 December 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
