| Regimental number | 50008 |
| Place of birth | Melbourne, Victoria |
| Religion | Presbyterian |
| Occupation | Traveller |
| Address | Stanley Parade, Caulfield, Victoria |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs H Black, Stanley Parade, Caulfield, Victoria |
| Enlistment date | 28 August 1917 |
| Rank on enlistment | Private |
| Unit name | 1st General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A34 Persic on 21 March 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia 24 July 1919 |
