| Regimental number | 4061 |
| Religion | Methodist |
| Occupation | Labourer |
| Address | 3 Bennie Street, Brunswick, Melbourne, Victoria |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs M Andrews, 3 Bennie Street, Brunswick, Melbourne, Victoria |
| Enlistment date | 25 November 1915 |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/38/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on 7 March 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
