| Regimental number | 4978 |
| Place of birth | Windsor England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o C S G Till, 225 Heytesbury Road, Subiaco, Western Australia |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs E Till, 19 Parry Street, Perth, Western Australia |
| Enlistment date | 11 January 1916 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A48 Seang Bee on 18 July 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
