| Regimental number | 643 |
| Place of birth | Collingwood Victoria |
| Religion | Roman Catholic |
| Occupation | Stationer |
| Address | Woodford, via Warrnambool, Victoria |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mrs F. Smith, Woodford, via Warrnambool, Victoria |
| Enlistment date | 19 September 1914 |
| Rank on enlistment | Private |
| Unit name | 4th Light Horse Regiment, 1st Reinforcement |
| AWM Embarkation Roll number | 10/9/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A43 Barunga on 22 December 1914 |
| Miscellaneous details (Nominal Roll) | nonrr |
