| Regimental number | 5195 |
| Place of birth | York Western Australia |
| Religion | Church of England |
| Occupation | Prospector |
| Address | Mandurah, Western Australia |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Father, Mr G Scrivener, Mandurah, Western Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A9 Shropshire on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |