| Regimental number | 4043 |
| Place of birth | Ballarat, Victoria |
| Religion | Roman Catholic |
| Occupation | Jockey |
| Address | George Street, Kalgoorlie, Western Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Grandparent, Mrs H Shepherd, 155 Wittenoom Street, Boulder, Western Australia |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/28/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board RMS Mongolia on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
