| Regimental number | 5463 |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Jengellic Creek, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Father, C Welch, C/o Ballarat PO, Victoria |
| Enlistment date | 17 November 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/19/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A4 Ceramic on 14 April 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
