| Regimental number | 1121 |
| Place of birth | Richmond Victoria |
| Religion | Church of England |
| Occupation | Lather |
| Address | Avonmore Avenue, North Norwood, South Australia |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs. Annie Wearne, Avonmore Avenue, North Norwood, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 3rd Light Horse Regiment, 7th Reinforcement |
| AWM Embarkation Roll number | 10/8/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A61 Kanowna on |
| Regimental number from Nominal Roll | 1121A |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 5th DTMB |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
