| Regimental number | 6714 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Waterside worker |
| Address | 58 Ross Street, Forest Lodge, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs A Clarke, Port Kembla PO, Port Kembla, New South Wales |
| Enlistment date | 22 July 1916 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/30/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT Port Nicholson on 8 November 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
