| Regimental number | 4900 |
| Place of birth | York Western Australia |
| Religion | Church of England |
| Occupation | Striker |
| Address | c/o Nurse Barker, Midland Junction, Western Australia |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs H Scrivener, 146 Newcastle Street, Perth, Western Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A38 Ulysses on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
