| Regimental number | 4960 |
| Religion | Church of England |
| Occupation | Linesman |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs J E Cooper, Counsel Street, Zeehan, Tasmania |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/29/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A70 Ballarat on |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |