| Regimental number | 2463 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 61 Mort Street, Balmain, New South Wales |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs Alice Agnes Cook, 29 Curtis Road, Balmain, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 1st Light Horse Regiment, 17th Reinforcement |
| AWM Embarkation Roll number | 10/6/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A39 Port Macquarie on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Light Horse Regiment |
| Fate | Returned to Australia |
| Other details | Medals: British War Medal, Victory Medal |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
