| Regimental number | 803 |
| Place of birth | Burra South Australia |
| Religion | Methodist |
| Occupation | Labourer |
| Address | c/o Mrs. Susan McCubbin, Chapel lane off Bromide Street, Broken Hill, New South Wales |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Mother, Mrs. Susan McCubbin, Chapel lane off Bromide Street, Broken Hill, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 9th Light Horse Regiment, 2nd Reinforcement |
| AWM Embarkation Roll number | 10/14/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A26 Armadale on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Light Horse Regiment |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
