| Regimental number | 5360 |
| Place of birth | Mallala South Australia |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Mallala, South Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs C Forby, Mallala, South Australia |
| Enlistment date | 12 January 1916 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/27/4 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A60 Aeneas on 11 April 1916 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia 16 June 1919 |