| Regimental number | 523 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Innisfail, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Aunt, Mrs Eliza Bloomcamp, Palmer Street, Collingwood, Victoria |
| Enlistment date | 25 August 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 12, Reinforcement 8 |
| AWM Embarkation Roll number | 24/17/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A7 Medic on 16 December 1916 |
| Miscellaneous details (Nominal Roll) | crossed out on n.r. |
