| Regimental number | 455 |
| Place of birth | Melbourne, Victoria |
| Religion | Roman Catholic |
| Occupation | Assistant storeman |
| Address | Oriel Road, Clayfield, Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs Ethel Mary Cook, Oriel Road, Clayfield, Brisbane, Queensland |
| Previous military service | 5th ASC |
| Enlistment date | 29 June 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 10, Reinforcement 6 |
| AWM Embarkation Roll number | 24/15/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A34 Persic on 22 December 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
