| Regimental number | 13210 |
| Religion | Church of England |
| Occupation | Motor mechanic |
| Address | 43 Macauley Road, Stanmore, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | Mother, Mrs Eugenie Coxon, 43 Macauley Road, Stanmore, Sydney, New South Wales |
| Previous military service | 38th Infantry |
| Enlistment date | 25 September 1916 |
| Rank on enlistment | Driver |
| Unit name | Auxiliary Mechanical Transport Company 2, Section 2 |
| AWM Embarkation Roll number | 25/113/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A34 Persic on 22 December 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
