| Regimental number | 1700 |
| Religion | Church of England |
| Occupation | Gatemaker |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mrs Annie Holmes, 8 Lynch Street, Carlton, Melbourne, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 21st Battalion, 2nd Reinforcement |
| AWM Embarkation Roll number | 23/38/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A64 Demosthenes on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |