| Regimental number | 68863 |
| Place of birth | Blackwood Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Blakeville via Ballan, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs M J Stephens, Blakeville via Ballan, Victoria |
| Enlistment date | 22 July 1918 |
| Rank on enlistment | Private |
| Unit name | 15th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A36 Boonah on 22 October 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
