| Regimental number | 3748 |
| Place of birth | Millicent South Australia |
| Religion | Church of England |
| Occupation | Clerk |
| Address | St Peters, South Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs Minnie Shaw, c/o Mrs Von Einen, Eighth Avenue, St Peters, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 50th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/67/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A32 Themistocles on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 50th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
