| Regimental number | 7104 |
| Place of birth | Mount Gambier South Australia |
| Religion | Methodist |
| Occupation | Baker |
| Address | Mount Gambier, South Australia |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | SA, Mrs F R V Cossons, Mount Gambier, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 23rd Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A35 Berrima on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
