| Regimental number | 3977 |
| Place of birth | Wagga Wagga New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | 97 Pitt Street, Waterloo, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, G Shipley, 97 Pitt Street, Waterloo, New South Wales |
| Enlistment date | 27 September 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/21/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 30 December 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
