| Regimental number | 8399 |
| Place of birth | Mackay Queensland |
| Religion | Roman Catholic |
| Occupation | Baker |
| Address | Metropolitan Fire Brigade, Brisbane, Queensland |
| Marital status | Married |
| Age at embarkation | 23 |
| Next of kin | Wife, Mrs M E Fredericks, c/o Mrs Harwicks, Boundary Street, West End, Brisbane, Queensland |
| Enlistment date | 4 September 1915 |
| Rank on enlistment | Private |
| Unit name | Field Ambulance 3, Reinforcement 13 |
| AWM Embarkation Roll number | 26/46/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A36 Boonah on 22 January 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 8th Field Ambulance |
| Fate | Returned to Australia 26 September 1917 |
