| Regimental number | 6601 |
| Place of birth | Tanunda South Australia |
| Religion | Methodist |
| Occupation | Packer |
| Address | Lameroo, South Australia |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Mother, Mrs A Yates, Angaston, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A16 Port Melbourne on |