| Regimental number | 5641 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Gardener |
| Address | 75 Undercliffe Street, Neutral Bay, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Amy Theobald, 75 Undercliffe Street, Neutral Bay, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 19th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
