| Regimental number | 1784 |
| Place of birth | Cooma New South Wales |
| Religion | Roman Catholic |
| Occupation | Shearer |
| Address | Cootamundra, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Mary Cullen, Albion Street, Paddington, Sydney, New South Wales |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 12th Light Horse Regiment, 9th Reinforcement |
| AWM Embarkation Roll number | 10/17/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Light Horse Regiment |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
