| Regimental number | 3626 |
| Place of birth | Omeo Victoria |
| Religion | Church of England |
| Occupation | Farm labourer |
| Address | Wangaratta, Victoria |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Uncle, S Raison, Green Street, Wangaratta, Victoria |
| Enlistment date | 14 January 1918 |
| Rank on enlistment | Private |
| Unit name | 58th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/75/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Ormonde on 7 March 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Division Train |
| Fate | Returned to Australia 25 September 1919 |
