| Regimental number | 8612 |
| Religion | Church of England |
| Occupation | Painter |
| Address | Same as next of kin |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mrs Mary Evans, 6 Bagot Street, Torrensville, South Australia |
| Rank on enlistment | Driver |
| Unit name | Field Artillery Brigade 6, Brigade Ammunition Column |
| AWM Embarkation Roll number | 13/34/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A34 Persic on |