| Regimental number | 3008 |
| Religion | Church of England |
| Occupation | Miner |
| Address | Cootamundra, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs R H Broadbent, Cootamundra, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/21/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A69 Warilda on |
| Fate | No details of fate entered on Nominal Roll |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
