| Religion | Church of England |
| Occupation | Miner |
| Address | 30 Tate Street, West Leederville, Western Australia |
| Marital status | Single |
| Age at embarkation | 36 |
| Next of kin | Mother, Mrs Mary Crouch, 28 Thane Villas, Holloway, England |
| Enlistment date | 19 September 1914 |
| Rank on enlistment | 2nd Lieutenant |
| Unit name | 16th Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/33/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A23 Suffolk on 13 October 1916 |
| Miscellaneous details (Nominal Roll) | missing page |
