| Regimental number | 2022 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Northam, Western Australia |
| Marital status | Single |
| Age at embarkation | 35 |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/28/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A20 Hororata on |
| Miscellaneous details (Nominal Roll) | nonrr |
| Medals |
Medaille Militaire (France) Source: 'Commonwealth Gazette' No. 23 Date: Military Medal Source: 'Commonwealth Gazette' No. 115 Date: |