| Regimental number | 4802 |
| Place of birth | Donald Victoria |
| Religion | Church of England |
| Occupation | Miner |
| Address | 40 James Street, Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 44 |
| Next of kin | Mother, Mrs E Koops, Pinjarrah, Western Australia |
| Enlistment date | 14 February 1916 |
| Date of enlistment from Nominal Roll | 28 January 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A38 Ulysses on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Veterinary Hospital |
| Fate | Returned to Australia 3 March 1919 |
