| Regimental number | 12613 |
| Place of birth | Burnley England |
| Religion | Church of England |
| Occupation | Clerk |
| Address | 21 Gover Street, North Adelaide, South Australia |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs Lena Fairburn, 6 Cromwell Street, Burnley, Lancashire, England |
| Enlistment date | |
| Rank on enlistment | Orderly Room SGT |
| Unit name | 11th Field Ambulance |
| AWM Embarkation Roll number | 26/54/1 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A29 Suevic on |
| Recommendations (Medals and Awards) |
Mention in Despatches Recommendation date: |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |