| Regimental number | 3784 |
| Place of birth | Norwich England |
| Religion | Church of England |
| Occupation | Fettler |
| Address | Kalgoorlie, Western Australia |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs Laura Burcham, 57 Duke Street, Norwich, England |
| Enlistment date | 1 December 1915 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A28 Miltiades on 12 February 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | aps HDQRS |
| Fate | Effective abroad (still overseas) |
