| Regimental number | 57875 |
| Place of birth | Goondiwindi Queensland |
| Religion | Roman Catholic |
| Occupation | Miner and horse breaker |
| Address | Moorang via Rosewood, Queensland |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs M C Lake, Moorang via Rosewood, Queensland |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | Queensland Reinforcement 5 |
| AWM Embarkation Roll number | 23/111/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A30 Borda on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | a Stag Camp |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
