| Regimental number | 16069 |
| Place of birth | Sevenoaks England |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Neutral Bay, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs A Theobald, Sevenoaks, Undercliffe Road, Neutral Bay, Sydney, New South Wales |
| Previous military service | 17th Infantry |
| Enlistment date | 1 March 1916 |
| Rank on enlistment | Sapper |
| Unit name | |
| AWM Embarkation Roll number | 22/17/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A41 Bakara on 4 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Signal Sqdn MDiv |
| Fate | Effective abroad (still overseas) |
