| Regimental number | 2647 |
| Place of birth | Crystal Brook South Australia |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Port Vincent, South Australia |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs Mary Jane Crouch, Port Vincent, South Australia |
| Enlistment date | 15 March 1916 |
| Rank on enlistment | Private |
| Unit name | 50th Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/67/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A16 Port Melbourne on 23 October 1916 |
| Miscellaneous details (Nominal Roll) | missing page |
