| Regimental number | 1762 |
| Religion | Church of England |
| Occupation | Blacksmith |
| Address | Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Sister, Mary Keyes, Bingera Street, West Bundaberg, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 2nd Light Horse Regiment, 12th Reinforcement |
| AWM Embarkation Roll number | 10/7/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A23 Suffolk on |
| Fate | No details of fate entered on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
