| Regimental number | 2391 |
| Place of birth | Essex England |
| Religion | Church of England |
| Occupation | Clerk |
| Address | 156 Nicholson Street, Fitzroy, Victoria |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Beatrice Crouch, 156 Nicholson Street, Fitzroy, Victoria |
| Enlistment date | 29 May 1916 |
| Rank on enlistment | Private |
| Unit name | 58th Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/75/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A9 Shropshire on 25 September 1916 |
| Miscellaneous details (Nominal Roll) | missing page |