| Regimental number | 1562 |
| Place of birth | Perth, Western Australia |
| Religion | Roman Catholic |
| Occupation | Warder |
| Address | 236 York Street, Subiaco, Western Australia |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Ivy May Douglas, 236 York Street,Subiaco, Western Australia |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 10th Light Horse Regiment, 12th Reinforcement |
| AWM Embarkation Roll number | 10/15/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT RMS Mongolia on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Light Horse Regiment |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
