
| Regimental number | 102 |
| Religion | Church of England |
| Occupation | Wood stainer |
| Address | 'Canaipa', Heston Road, Kelvin Grove, Brisbane, New South Wales |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Mother, Mrs Annie Smith, 'Canaipa', Heston Road, Kelvin Grove, Brisbane, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Australian Naval & Military Expeditionary Force (Queensland Reinforcement) |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |