| Regimental number | 66794 |
| Place of birth | Tennessee United States Of America |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Surry Hills PO, Surry Hills, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Cousin, W Simmons, Greenfield, Tennessee, USA |
| Enlistment date | 27 August 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 22 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Wyreema on 14 October 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
