| Regimental number | 170 |
| Place of birth | Loire France |
| Religion | Roman Catholic |
| Occupation | Cook |
| Address | 21 Rue Virginie, Marseilles, France |
| Marital status | Single |
| Age at embarkation | 38 |
| Next of kin | Mother, Mrs Marie Pomaret Derois, 21 Rue Virginie, Marseilles, France |
| Enlistment date | 10 March 1915 |
| Rank on enlistment | Private |
| Unit name | 20th Battalion, A Company |
| AWM Embarkation Roll number | 23/37/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A35 Berrima on 25 June 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 20th Battalion |
| Fate | Effective abroad (still overseas) |
