| Regimental number | 19276 |
| Religion | Church of England |
| Occupation | Farm hand |
| Address | 168 Norton Street, Leichhardt, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Mabel Storum, 168 Norton Street, Leichhardt, Sydney, New South Wales |
| Enlistment date | 18 April 1917 |
| Rank on enlistment | Private |
| Unit name | 1st Light Horse Field Ambulance, 31st Reinforcement |
| AWM Embarkation Roll number | 26/39/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A73 Commonwealth on 2 November 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 14th Australian General Hospital |
| Fate | Returned to Australia 2 August 1919 |
