| Regimental number | 6212 |
| Place of birth | Dalby Queensland |
| Religion | Roman Catholic |
| Occupation | Cook |
| Address | 349 Miller Street, North Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs Angela Dormer, 349 Miller Street, North Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A11 Ascanius on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 24th Depot Unit of Supply |
| Fate | Returned to Australia |
Postal Address:
Po Box 7916
Canberra BC 2610, Australia
Street Address:
Northcott Drive,
Campbell, ACT 2600
