| Regimental number | 6003 |
| Religion | Church of England |
| Occupation | Furniture estimator |
| Address | 6 North Avenue, Leichhardt, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 42 |
| Next of kin | Wife, Mrs A W Frederick, 6 North Avenue, Leichhardt, Sydney, New South Wales |
| Enlistment date | 29 November 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 22 August 1916 |
| Regimental number from Nominal Roll | 6003A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 21 July 1918 |
