| Regimental number | 3294 |
| Place of birth | Lismore New South Wales |
| Religion | Church of England |
| Occupation | Butter packer |
| Address | Nimbin, New South Wales |
| Marital status | Married |
| Age at embarkation | 26 |
| Next of kin | Wife, Mrs Ellen Fredericks, c/o James Fredericks, Oakleigh, Nimbin, New South Wales |
| Previous military service | 4th ALH |
| Enlistment date | 26 April 1917 |
| Rank on enlistment | Private |
| Unit name | 41st Battalion, 8th Reinforcement |
| AWM Embarkation Roll number | 23/58/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on 14 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 41st Battalion |
| Fate | Returned to Australia 12 June 1919 |
