| Regimental number | 2764 |
| Place of birth | Lichfield England |
| Religion | Church of England |
| Occupation | Shunter |
| Address | Midland Juntion, Western Australia |
| Marital status | Single |
| Age at embarkation | 31 |
| Next of kin | Mother, Mrs Elizabeth Haynes, Portland House, Butts Road, Walsall, Enlgland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 51st Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/68/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A23 Suffolk on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 51st Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
