| Regimental number | 5762 |
| Religion | Congregational |
| Occupation | Carpenter |
| Address | 25 Acacia Street, Elsternwick, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, Mr E Smith, 25 Acacia Street, Elsternwick, Victoria |
| Enlistment date | 14 February 1916 |
| Rank on enlistment | Private |
| Unit name | 5th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/22/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A14 Euripides on 4 April 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
