| Religion | Church of England |
| Occupation | Clerk in Holy Orders |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Mother, Mrs W M Statt, 7 Thorncliffe Road, Summertown, Oxford, England |
| Enlistment date | |
| Rank on enlistment | Chaplain (4th Class) |
| Unit name | Chaplains' Corps |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A35 Berrima on |
| Miscellaneous details (Nominal Roll) | see other |