| Regimental number | 417 |
| Place of birth | Freemantle, Western Australia |
| Religion | Protestant |
| Occupation | Labourer |
| Address | 52 Bellevue Terrace, Fremantle, Western Australia |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | ..., Mrs. J.P. Cook, 52 Bellevue Terrace, Fremantle, Western Australia |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, D Company |
| AWM Embarkation Roll number | 23/28/1 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A11 Ascanius on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Pioneer Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
