| Regimental number | 3926 |
| Religion | Church of England |
| Occupation | Bushman |
| Address | Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 35 |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 15th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/32/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A23 Suffolk on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |