| Regimental number | 6121 |
| Religion | Church of England |
| Occupation | Bus driver |
| Address | C/o Mrs R Allan, Narrabri, New South Wales |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Father, E C Stacey, Rockhampton, Queensland |
| Enlistment date | 31 August 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/19/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 22 August 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
