| Regimental number | 1566 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 30 Lane Cove Road, Paddington, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Diana Elizabeth Cook, 30 Lane Cove Road, Paddington, Sydney, New South Wales |
| Enlistment date | 25 August 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Light Horse Regiment, 12th Reinforcement |
| AWM Embarkation Roll number | 10/7/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A23 Suffolk on 30 November 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
