| Regimental number | 6508 |
| Religion | Church of England |
| Occupation | Fisherman |
| Address | Napoleon Street, Sans Souci, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs. J. Douglas, Napoleon Street, Sans Souci, New South Wales |
| Enlistment date | 10 July 1916 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 7 October 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |