| Regimental number | 1120 |
| Place of birth | Deep Water New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Boggabilla, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Mary Ann Adams, Boggabilla, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Light Horse Regiment, 5th Reinforcement |
| AWM Embarkation Roll number | 10/17/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A32 Themistocles on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Field Squadron Engineers |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
