| Regimental number | 3919 |
| Place of birth | Bega New South Wales |
| Religion | Church of England |
| Occupation | Jackeroo |
| Address | Coff's Harbour, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs. Ellen Gay Secombe, Coff's Harbour, New South Wales |
| Enlistment date | 22 February 1916 |
| Rank on enlistment | Private |
| Unit name | 31st Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/48/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A49 Seang Choon on 19 September 1916 |
