| Regimental number | 62643 |
| Place of birth | Adelaide, South Australia |
| Religion | Roman Catholic |
| Occupation | Traveller |
| Address | Renmark, South Australia |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs A Wyatt, Tenth Street, Renmark, South Australia |
| Enlistment date | 14 October 1918 |
| Rank on enlistment | Private |
| Unit name | 6th General Service Reinforcements |
| AWM Embarkation Roll number | 23/111/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A36 Boonah on 22 October 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
