| Regimental number | 3496 |
| Place of birth | Adelaide South Australia |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Southbrook, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs. Alice Tischler, G.P.O., Sydney, New South Wales |
| Enlistment date | 5 October 1917 |
| Rank on enlistment | Private |
| Unit name | 2nd Light Horse Regiment, 30th Reinforcement |
| AWM Embarkation Roll number | 10/7/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT HMAT A38 Ulysses on 19 December 1917 |
| Miscellaneous details (Nominal Roll) | missing page |