| Regimental number | 65828 |
| Place of birth | Goulburn New South Wales |
| Religion | Church of England |
| Occupation | Grocer |
| Address | North Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs C Shrimpton, c/o E Boreham, The Elms, Ginninderra, Queanbeyan, New South Wales |
| Enlistment date | 8 May 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 18 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A41 Bakara on 4 September 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
