| Regimental number | 5057 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Baker |
| Address | Fitzgerald Street, Northam, Western Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, F C Broomhall, Fitzgerald Street, Northam, Western Australia |
| Enlistment date | 20 January 1916 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A9 Shropshire on 31 March 1916 |
| Regimental number from Nominal Roll | 5057A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 15 February 1918 |
