| Regimental number | 66539 |
| Place of birth | England |
| Religion | Church of England |
| Occupation | Horse dealer |
| Address | Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 38 |
| Next of kin | Sister, Mrs O E Addis, 32 Durban Street, Glebe, Sydney, New South Wales |
| Enlistment date | 24 June 1918 |
| Place of enlistment | Sydney, New South Wales |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 21 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A36 Boonah on 22 October 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
