| Regimental number | 612 |
| Place of birth | Oodla Wirra South Australia |
| Religion | Methodist |
| Occupation | Labourer |
| Address | Port Pirie West, South Australia |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Father, W H Warner, Port Pirie West, South Australia |
| Enlistment date | 9 November 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 8, Reinforcement 10 |
| AWM Embarkation Roll number | 24/13/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Omrah on 17 January 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
