| Regimental number | 1667 |
| Religion | Church of England |
| Occupation | Grocer |
| Address | Northcote, Victoria |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Annie Burnard, 7 Watson Street, Armadale, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 58th Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/75/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A14 Euripides on |
| Fate | No details of fate entered on Nominal Roll |