| Regimental number | 4863 |
| Religion | Roman Catholic |
| Occupation | Farmer |
| Address | Eton, Mackay, Queensland |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Mother, Mrs J O Broadhead, Bungonia, New South Wales |
| Enlistment date | 2 November 1915 |
| Rank on enlistment | Sapper |
| Unit name | |
| AWM Embarkation Roll number | 16/13/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A69 Warilda on 22 May 1916 |
