| Regimental number | 219 |
| Place of birth | Perth Western Australia |
| Religion | Church of England |
| Occupation | Horse breaker |
| Address | Amy Street, Spring Hill, Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Sister, Mrs G Vander Warden, 27 Amy Street, Spring Hill, Brisbane, Queensland |
| Enlistment date | 11 March 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Light Horse Regiment, A Squadron |
| AWM Embarkation Roll number | 10/16/1 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A7 Medic on 2 June 1915 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A30 Borda on 16 June 1915 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
