| Regimental number | 6391A |
| Place of birth | Geraldton Western Australia |
| Religion | Wesleyan |
| Occupation | Cordial manufacturer |
| Address | 6 Bulwet Street, North Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Mother, Mrs W Jose, 6 Bulwet Street, North Perth, Western Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Divisional Train 2,Army Service Corps 16, Reinforcement 11 |
| AWM Embarkation Roll number | 25/15/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Service Corps |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
