| Regimental number | 3015 |
| Religion | Church of England |
| Occupation | Factory hand |
| Address | Blackboy Hill, Western Australia |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Sister, Miss Myrtle Shulz, Booleroo Centre, South Australia |
| Enlistment date | 13 April 1916 |
| Rank on enlistment | Private |
| Unit name | 10th Light Horse Regiment, 22nd Reinforcement |
| AWM Embarkation Roll number | 10/15/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A41 Bakara on 4 November 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
