| Regimental number | 4112 |
| Religion | Methodist |
| Occupation | Grocer |
| Address | Baw Baw via Goulburn, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs S Clements, Baw Baw PO via Goulburn, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/36/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on |