| Regimental number | 14474 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Motor mechanic |
| Address | South Yarra, Victoria |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs Ada Marion Anniss, 442 Punt Hill, South Yarra, Victoria |
| Enlistment date | 15 September 1916 |
| Rank on enlistment | Motor Transport Driver |
| Unit name | Mechanical Transport Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 11 May 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
