| Regimental number | 1630 |
| Place of birth | Ballarat Victoria |
| Religion | Church of England |
| Occupation | Plasterer |
| Address | Grattan Street, Carlton, Victoria |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Emily Verey, Grattan Street, Carlton, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Light Horse Regiment, 6th Reinforcement |
| AWM Embarkation Roll number | 10/17/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT RMS Moldavia on |
| Rank from Nominal Roll | Trooper |
| Unit from Nominal Roll | 12th Light Horse Regiment |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
