| Regimental number | 1079 |
| Place of birth | Daisy Hill England |
| Religion | Church of England |
| Occupation | Miner |
| Address | Clermont, Queensland |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs Alice Maud Mary Forshaw, Daisyhill, Bolton, Lancashire, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 42nd Battalion, D Company |
| AWM Embarkation Roll number | 23/59/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A30 Borda on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Field Ambulance |
| Fate | Effective abroad (still overseas) |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
