| Regimental number | 18782 |
| Place of birth | Ballarat, Victoria |
| Religion | Roman Catholic |
| Occupation | Butcher |
| Address | Ballarat, Victoria |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Bridget Braybrook, corner of Mair and Drummond Streets, Ballarat, Victoria |
| Previous military service | 19th Light Horse |
| Enlistment date | |
| Rank on enlistment | Sapper |
| Unit name | Divisional Signal Company 3, Engineer Reinforcements 12 |
| AWM Embarkation Roll number | 22/13/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A32 Themistocles on |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | Corps Signal Company |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
