| Regimental number | 470 |
| Place of birth | Seymour Victoria |
| Religion | Church of England |
| Occupation | Driver |
| Address | Tallarook Street, Seymour, Victoria |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Wife, Mrs Elsie L Shattock, c/o D Johnston, Tallarook Street, Seymour, Victoria |
| Enlistment date | 13 September 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 15, Reinforcement 7 |
| AWM Embarkation Roll number | 24/20/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 25 October 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |