| Regimental number | 67763 |
| Place of birth | Sydney New South Wales |
| Religion | Methodist |
| Occupation | Cook |
| Address | 332 Riley Street, Surry Hills, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Sister, Mrs A Carstens, Meeker, Rio Blanco, county Colorado, USA |
| Enlistment date | 13 May 1918 |
| Rank on enlistment | Private |
| Unit name | New South Wales Reinforcement 26 |
| AWM Embarkation Roll number | 23/111/6 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 2 November 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
