| Regimental number | 3072 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Kitchener Road, Lamington Kalgoorlie, Western Australia |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs M Ellsworthy, Kitchener Road, Lamington, Kalgoorlie, Western Australia |
| Enlistment date | 13 July 1915 |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/29/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A32 Themistocles on 13 October 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
