| Regimental number | 69019 |
| Place of birth | Warracknabeal Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Palace Hotel, Warracknabeal, Victoria |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs M Cooper, Palace Hotel, Warracknabeal, Victoria |
| Previous military service | 2nd Battalion 21st Infantry |
| Enlistment date | 22 August 1918 |
| Rank on enlistment | Private |
| Unit name | 16th General (Victorian) Reinforcements |
| AWM Embarkation Roll number | 23/111/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Carpentaria on 7 November 1918 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
