| Regimental number | 1069 |
| Place of birth | Glen Osmond South Australia |
| Occupation | Bushman |
| Address | 44 East Terrace, Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mrs T. L. Hayward, 44 East Terrace, Adelaide, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 4th Light Horse Regiment, 6th Reinforcement |
| AWM Embarkation Roll number | 10/9/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 3rd Field Company Engineers |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
