| Regimental number | 5091 |
| Place of birth | Poowong Victoria |
| Religion | Presbyterian |
| Occupation | Farmer |
| Address | Bena, South Gippsland, Victoria |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs Margaret Timms, Bena South Gippsland, Victoria |
| Enlistment date | 6 March 1916 |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/38/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A33 Ayrshire on 3 July 1916 |
| Miscellaneous details (Nominal Roll) | missing page |