| Regimental number | 4166 |
| Place of birth | Orvide, Victoria |
| Religion | Church of England |
| Occupation | Schoolmaster |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Father, J F Chivers, Emu, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | Australian Stationary Hospital 2, Reinforcement 7 |
| AWM Embarkation Roll number | 26/71/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A64 Demosthenes on |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 2nd Light Horse Field Ambulance |
| Recommendations (Medals and Awards) |
Mention in Despatches Recommendation date: |
| Fate | Effective abroad (still overseas) |