| Regimental number | 3513 |
| Place of birth | Adelaide, South Australia |
| Religion | Church of England |
| Occupation | Miner |
| Address | Lismore, New South Wales |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs A G Bertram, Ansty Street, Lismore, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 41st Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/58/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Ormonde on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 41st Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
