| Regimental number | 3802 |
| Religion | Church of England |
| Occupation | Bank clerk |
| Address | Davies Street, Charters Towers, Queensland |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs Adelaide De Vis, Davies Street, Charters Towers, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 25th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/42/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT Wandilla on |