| Regimental number | 66428 |
| Place of birth | Bombala New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Cathcart, New South Wales |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Mother, Mrs E Bourke, Cathcart, New South Wales |
| Enlistment date | 24 June 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 21 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A36 Boonah on 22 October 1918 |
| Fate | No details of fate entered on Nominal Roll |
