| Regimental number | 2465 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Church Street, Lidcombe, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs Kate DeRome, Church Street, Lidcombe, Sydney, New South Wales |
| Enlistment date | 6 October 1915 |
| Rank on enlistment | Private |
| Unit name | 7th Light Horse Regiment, 17th Reinforcement |
| AWM Embarkation Roll number | 10/12/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A39 Port Macquarie on 26 April 1916 |
