| Regimental number | 2017 |
| Place of birth | Brisbane Queensland |
| Religion | Church of England |
| Occupation | Carter |
| Address | Musgrave Road, Red Hill, Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Alice Maud Fernandez, Musgrave Road, Red Hill, Brisbane, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, 14th Reinforcement |
| AWM Embarkation Roll number | 10/10/3 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A62 Wandilla on |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 13th Field Artillery Brigade |
| Recommendations (Medals and Awards) |
Military Medal (Immediate) Recommendation date: |
| Fate | Returned to Australia |