| Regimental number | 53802 |
| Place of birth | Evans Head New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Palmer's Island, Clarence River, New South Wales |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs F V Souter, Palmer's Island, Clarence River, New South Wales |
| Enlistment date | 28 February 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 4 |
| AWM Embarkation Roll number | 23/111/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Feldmarschall on 19 June 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
