| Regimental number | 5395 |
| Place of birth | Chelmsford England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Co Mrs Wagner, Cemetery Road, Nundah, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs E Jordan, Hemp Cottage, Moulsham Chelmsford, England |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 9th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/26/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Hawkes Bay on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
