| Regimental number | 6065 |
| Place of birth | Lancefield, Victoria |
| Religion | Church of England |
| Occupation | Tram conductor |
| Address | Hemming Street, Dandenong, Victoria |
| Marital status | Married |
| Age at embarkation | 23 |
| Next of kin | Wife, Mrs Mary Cooper, Hemming Street, Dandenong, Victoria |
| Enlistment date | 25 April 1916 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/39/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A8 Argyllshire on 31 October 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
