| Regimental number | 2221 |
| Place of birth | Carlton Victoria |
| Religion | Church of England |
| Occupation | Stableman |
| Address | c/o Nurse Abbott, East Victoria Park, Western Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs A. Roberts, c/o Nurse Abbott, East Victoria Park, Western Australia |
| Enlistment date | 19 April 1915 |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/22/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 25 June 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
