| Regimental number | 3619 |
| Place of birth | Grimsby, England |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Toowoomba, Queensland |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs A Taylor, 39 David Street, Grimsby, England |
| Enlistment date | 4 January 1918 |
| Place of enlistment | Toowoomba, Queensland |
| Rank on enlistment | Private |
| Unit name | 41st Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/58/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Ormonde on 2 March 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
