| Regimental number | 490 |
| Place of birth | Red Hill, South Australia |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Gawler South, South Australia |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mrs C Collins, Gawler South, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Light Horse Regiment, C Squadron |
| AWM Embarkation Roll number | 10/16/1 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A7 Medic on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
