| Regimental number | 1879 |
| Place of birth | Sydney New South Wales |
| Religion | Presbyterian |
| Occupation | Wheeler |
| Address | Gillies Street, Kurri Kurri, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs M Ansell, Gillies Street, Kurri Kurri, New South Wales |
| Enlistment date | 12 June 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A54 Runic on 9 August 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
