| Regimental number | 110 |
| Place of birth | Swan Hill, Victoria |
| Religion | Church of England |
| Occupation | Horse breaker |
| Address | Terminus Hotel, Hay, New South Wales |
| Marital status | Single |
| Age at embarkation | 38 |
| Next of kin | Sister, Mrs Elizabeth Beasy, Swan Hill, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Light Horse Regiment, A Squadron |
| AWM Embarkation Roll number | 10/17/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A29 Suevic on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Army Provost Corps |
| Miscellaneous details (Nominal Roll) | No details of fate entered on Nominal Roll. |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
