| Regimental number | 3780 |
| Place of birth | Ballina New South Wales |
| Religion | Protestant |
| Occupation | Labourer |
| Address | Ballina, Richmond River, New South Wales |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs Johanna Bourke, Ballina, Richmond River, New South Wales |
| Enlistment date | 14 September 1915 |
| Rank on enlistment | Private |
| Unit name | 25th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/42/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT Wandilla on 31 January 1916 |
