| Regimental number | 396 |
| Place of birth | Fryerstone Victoria |
| Religion | Methodist |
| Occupation | Saddler |
| Address | 217 Gore Street, Fitzroy, Victoria |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Father, E. Cozens, 217 Gore Street, Fitzroy, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 9th Light Horse Regiment, C Squadron |
| AWM Embarkation Roll number | 10/14/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A10 Karroo 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
