| Regimental number | 3927 |
| Place of birth | Brunswick Victoria |
| Religion | Church of England |
| Occupation | Plasterer |
| Address | 48 Bennett Street, North Fitzroy Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs C Storey, 48 Bennett Street, North Fitzroy Melbourne, Victoria |
| Enlistment date | 13 August 1915 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/27/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board RMS Malwa on 2 December 1915 |
