| Regimental number | 69228 |
| Religion | Church of England |
| Occupation | Clerk |
| Address | 240 Barker's Road, Glenferrie, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs M Adams, 223 Charles Street, Launceston, Tasmania |
| Enlistment date | 3 September 1918 |
| Rank on enlistment | Private |
| Unit name | 17th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 2 November 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
