| Regimental number | 2021 |
| Place of birth | Adelaide South Australia |
| Religion | Baptist |
| Occupation | Labourer |
| Address | Stepney Street, St Peters, Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs G Selby, Stepney Street, Adelaide, South Australia |
| Enlistment date | 21 March 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/21/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 13 April 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
