| Regimental number | 514202 |
| Place of birth | Stourbridge England |
| Religion | Church of England |
| Occupation | Soldier |
| Address | Croydon, New South Wales |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs N Broadhurst, Ingledene, Bay Street, Croydon, New South Wales |
| Enlistment date | 20 July 1918 |
| Rank on enlistment | Warrant Officer (Class II) |
| Unit name | Staffs in Charge Italian Reservists No 3 Draft |
| AWM Embarkation Roll number | 34/13/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Gaika on 30 July 1918 |
| Rank from Nominal Roll | Warrant Officer (Class II) |
| Unit from Nominal Roll | Special Service Unit |
| Fate | Returned to Australia 20 November 1918 |
