| Regimental number | 3734 |
| Place of birth | Port Fairy Victoria |
| Religion | Church of England |
| Occupation | Gentleman |
| Address | Mornington, Victoria |
| Marital status | Widower |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs M Waller, 3 Daisy Street, Essendon, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 58th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/75/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Ormonde on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 58th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
