| Regimental number | 3121 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Loco fireman |
| Address | Murwillumbah, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs. Florence Lavina Small, Camira Creek, via Grafton, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 2nd Light Horse Regiment, 24th Reinforcement |
| AWM Embarkation Roll number | 10/7/5 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A1 Hymettus on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Light Horse Regiment |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
