| Regimental number | 5004 |
| Place of birth | Napier, New Zealand |
| Religion | Roman Catholic |
| Occupation | Saughterman |
| Address | 5 Bute Street, Footscray, Victoria |
| Marital status | Single |
| Age at embarkation | 26 |
| Next of kin | Mother, Mrs Rose Vickery, 5 Bute Street, Footscray, Melbourne, Victoria |
| Enlistment date | |
| Place of enlistment | Seymour, Victoria |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/39/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A33 Ayrshire on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |