| Regimental number | 1117 |
| Religion | Church of England |
| Occupation | Farm labourer |
| Address | Abertridwa near Cardiff, South Wales |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs Emily Bevan, Abertridwa near Cardiff, South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 10th Light Horse Regiment, 7th Reinforcement |
| AWM Embarkation Roll number | 10/15/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A61 Kanowna on |