| Regimental number | 1106 |
| Place of birth | Port Fairy Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Bank Street, Port Fairy, Victoria |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Mother, Mrs M A Lane, Bank Street, Port Fairy, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, A Company |
| AWM Embarkation Roll number | 23/47/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
