| Regimental number | 5109 |
| Religion | Church of England |
| Occupation | Marine stoker |
| Address | East Fremantle, Western Australia |
| Marital status | Married |
| Age at embarkation | 34 |
| Next of kin | Wife, Mrs Rosina Mary Ann Williams, rear 118 Quarry Street, East Fremantle, Western Australia |
| Enlistment date | 6 March 1916 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A48 Seang Bee on 18 July 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |