| Regimental number | 69115 |
| Place of birth | Hawthorn Victoria |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Boat Harbor, Tasmania |
| Marital status | Married |
| Age at embarkation | 43 |
| Next of kin | Wife, Mrs I Squires, Boat Harbor, Tasmania |
| Enlistment date | 22 July 1918 |
| Rank on enlistment | Private |
| Unit name | 16th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Carpentaria on 7 November 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |