| Regimental number | 3116 |
| Religion | Church of England |
| Occupation | Cook |
| Address | Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 42 |
| Next of kin | Cousin, Miss Rose Clark, c/o Millers Feather Shop, Swanston Street, Melbourne, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 4th Light Horse Regiment, 24th Reinforcement |
| AWM Embarkation Roll number | 10/9/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A67 Orsova on |