| Regimental number | 6333 |
| Religion | Church of England |
| Occupation | Station overseer |
| Address | 'Wyuna', Geelong, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Father, Frederick Douglass, 'Wyuna', Geelong, Victoria |
| Enlistment date | |
| Rank on enlistment | Driver |
| Unit name | Field Artillery Brigade 4, Battery 10 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on |