| Regimental number | 17551 |
| Place of birth | Geelong, Victoria |
| Religion | Church of England |
| Occupation | Cook |
| Address | Miller's Point, New South Wales |
| Marital status | Single |
| Age at embarkation | 36 |
| Next of kin | Friend, Mrs F Norris, 47 York Street, Miller's Point, New South Wales |
| Enlistment date | 19 April 1916 |
| Date of enlistment from Nominal Roll | 30 March 1916 |
| Rank on enlistment | Private |
| Unit name | April 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on 14 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Australian General Hospital |
| Fate | Effective abroad (still overseas) |
