| Regimental number | 743 |
| Place of birth | Rockhampton Queensland |
| Religion | Church of England |
| Occupation | Labourer |
| Address | C/o General Post Office Sarina via Mackay, Sarina via Mackay, Queensland |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Brother, Harry Self, West Plane Creek via Mackay, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 41st Battalion, C Company |
| AWM Embarkation Roll number | 23/58/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A64 Demosthenes on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 41st Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
