| Regimental number | 4866 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Newtown, Maryborough, Queensland |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Brother, C Dancer, Hill Street, Ipswich, Queensland |
| Enlistment date | 3 February 1916 |
| Rank on enlistment | Sapper |
| Unit name | |
| AWM Embarkation Roll number | 16/13/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A69 Warilda on 22 May 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
