| Regimental number | 3063 |
| Place of birth | Inverell New South Wales |
| Religion | Church of England |
| Occupation | Stockman |
| Address | Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Mother, Mrs Amelia Wiskens, Holm Farm, Inverell, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, 23rd Reinforcement |
| AWM Embarkation Roll number | 10/10/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A42 Boorara on |