| Regimental number | 14624 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Stone cutter |
| Address | North Adelaide, South Australia |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs L J Tavender, 36 Archer Street, North Adelaide, South Australia |
| Enlistment date | 26 January 1916 |
| Rank on enlistment | Private |
| Unit name | Australian Army Medical Corps, July 1916 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A53 Itria on 14 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Field Ambulance |
| Fate | Effective abroad (still overseas) |
