| Regimental number | 19 |
| Religion | Methodist |
| Occupation | Miner |
| Address | Penrew Farm, Pontypridd, Glamorgan, South Wales, England |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Mother, Mrs Jane Evans, Penrew Farm, Pontypridd, Glamorgan, South Wales, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Australian Naval & Military Expeditionary Force (Queensland Reinforcement) |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |