| Regimental number | 66685 |
| Place of birth | Bradford England |
| Religion | Methodist |
| Occupation | Carpenter |
| Address | 'Manningham', Albyn Street, Rockdale, New South Wales |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs C Derry, 'Manningham', Albyn Street, Rockdale, New South Wales |
| Enlistment date | 14 June 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 22 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Wyreema on 14 October 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
