| Regimental number | 763 |
| Religion | Church of England |
| Occupation | Motor mechanic and electrician |
| Address | Vailima, Ranges Road, Neutral Bay, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs E Hazelwood, Vailima, Ranges Road, Neutral Bay, Sydney, New South Wales |
| Enlistment date | 16 October 1916 |
| Rank on enlistment | Private |
| Unit name | Australian Flying Corps, No 2 Squadron, C Flight |
| AWM Embarkation Roll number | 8/5/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 25 October 1916 |
| Miscellaneous details (Nominal Roll) | see other |
