| Regimental number | 3082 |
| Religion | Church of England |
| Occupation | Brickmaker |
| Address | Spring Garden Street, Granville, New South Wales |
| Marital status | Married |
| Age at embarkation | 21 |
| Next of kin | Wife, Mrs K M Derome, 46 Auburn Road, Auburn, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 7th Reinforcement |
| AWM Embarkation Roll number | 23/36/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A29 Suevic on |