| Regimental number | 2420 |
| Religion | Church of England |
| Occupation | Horse breaker |
| Address | Gayndah, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Emily Coochy c/o Mrs Ivy Matthews, Gayndah, Queensland |
| Enlistment date | 10 November 1915 |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, 16th Reinforcement |
| AWM Embarkation Roll number | 10/10/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A47 Mashobra on 5 April 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
