| Regimental number | 4002 |
| Religion | Church of England |
| Occupation | Sleeper cutter |
| Address | Donnybrook, Western Australia |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs E M R Stevens, Armadale, Western Australia |
| Enlistment date | 23 August 1915 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A31 Ajana on 22 December 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
