| Regimental number | 4636 |
| Place of birth | Melbourne Victoria |
| Religion | Methodist |
| Occupation | Farmer |
| Address | ... |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Friend, Mrs C Pyke, Avon Terrace, York, Western Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A28 Miltiades on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 51st Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
