| Regimental number | 62783 |
| Place of birth | Perth, Western Australia |
| Religion | Church of England |
| Occupation | Whipmaker |
| Address | Midland Junction, Western Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Sister, Miss F Cleverly, c/o Mrs Latee, Henry Street, Midland Junction, Western Australia |
| Previous military service | 3rd Battalion 44th Infantry |
| Enlistment date | 22 July 1918 |
| Rank on enlistment | Private |
| Unit name | Western Australian Reinforcement 3 |
| AWM Embarkation Roll number | 23/111/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT Boonah on 29 October 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
