| Regimental number | 4643 |
| Place of birth | Coromandel Valley South Australia |
| Religion | Church of England |
| Occupation | ... |
| Address | Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Mother, Mrs H Sullivan, Blackwood, South Australia |
| Enlistment date | 14 September 1915 |
| Date of enlistment from Nominal Roll | 25 September 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A28 Miltiades on 12 February 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 51st Battalion |
| Fate | Effective abroad (still overseas) |
