| Regimental number | 6611 |
| Religion | Church of England |
| Occupation | Miner and motor driver |
| Address | PO, Norseman, Western Australia |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Annie Constance Dickenson, Victoria Street, Cue, Western Australia |
| Enlistment date | 17 April 1916 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/33/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A23 Suffolk on 13 October 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |