| Regimental number | 4079 |
| Place of birth | Launceston, Tasmania |
| Religion | Church of England |
| Occupation | Cook |
| Address | Launceston, Tasmania |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Mother, Mrs A Avery, 141 Patterson Street, Launceston, Tasmania |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 15th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/32/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT RMS Orontes on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
