| Regimental number | 2003 |
| Place of birth | Ararat, Victoria |
| Religion | Roman Catholic |
| Occupation | Farmer |
| Address | Collingwood, Victoria |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Annie Quine, 63 Gold Street, Collingwood, Victoria |
| Enlistment date | 3 April 1916 |
| Place of enlistment | Melbourne, Victoria |
| Rank on enlistment | Private |
| Unit name | 46th Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/63/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A30 Borda on 5 June 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
