| Regimental number | 41O |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Granville, Maryborough, Queensland |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs F Back, Granville, Maryborough, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 15th Battalion, C Company |
| AWM Embarkation Roll number | 23/32/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on |
| Miscellaneous details (Nominal Roll) | See other |