| Regimental number | 4791 |
| Place of birth | Norwood South Australia |
| Religion | Church of England |
| Occupation | Typewriting mechanic |
| Address | c/o Mrs Sully, Porter Street, Parkside, South Australia |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs E Sully, Porter Street, Parkside, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Australian General Hospital 3, Reinforcement 1 |
| AWM Embarkation Roll number | 26/67/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A62 Wandilla on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
| Date of death | |
| Place of burial | Centennial Park Cemetery |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
