| Regimental number | 3023 |
| Place of birth | Darlington New South Wales |
| Religion | Church of England |
| Occupation | Assistant salesman |
| Address | Wollongong Road, Arncliffe, New South Wales |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mother, Mrs A Crouch, Wollongong Road, Arncliffe, New South Wales |
| Enlistment date | 27 June 1915 |
| Rank on enlistment | Private |
| Unit name | 1st Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/18/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A69 Warilda on 8 October 1915 |
| Miscellaneous details (Nominal Roll) | missing page |
