| Regimental number | 4662 |
| Place of birth | Gympie Queensland |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Clara Black, Coates Street, Mount Morgan, Queensland |
| Enlistment date | |
| Date of enlistment from Nominal Roll | |
| Rank on enlistment | Private |
| Unit name | 25th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/42/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mooltan on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
