| Regimental number | 784 |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Albert Coffee, Passfield Street, Brunswick, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 4th Light Horse Regiment, 3rd Reinforcement |
| AWM Embarkation Roll number | 10/9/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A13 Katuna on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
