| Regimental number | 1430 |
| Place of birth | Orroroo South Australia |
| Religion | Church of England |
| Occupation | Carrier |
| Address | Petersburg, South Australia |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Katherine Forth, Petersburg, South Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Light Horse Regiment, 7th Reinforcement |
| AWM Embarkation Roll number | 10/16/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A2 Geelong on |
| Rank from Nominal Roll | 2nd Corporal |
| Unit from Nominal Roll | 2nd Field Company Engineers |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
