| Regimental number | 67612 |
| Place of birth | Petersham New South Wales |
| Religion | Church of England |
| Occupation | Clerk |
| Address | 52 John Street, Petersham, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 36 |
| Next of kin | Mother, Mrs L K Debelle, 52 John Street, Petersham, Sydney, New South Wales |
| Enlistment date | 30 August 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 26 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 2 November 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |