| Regimental number | 782 |
| Rank on enlistment | Private |
| Unit name | 10th Light Horse Regiment, 3rd Reinforcement |
| AWM Embarkation Roll number | 10/15/2 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A50 Itonus on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |