| Regimental number | 4124 |
| Place of birth | Wyong New South Wales |
| Religion | Church of England |
| Occupation | Farmer |
| Address | Dinley Dell Farm, Rooty Hill, New South Wales |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Sister, Mrs A M L Lloyd, The Crescent, Parsley Bay, New South Wales |
| Enlistment date | 6 December 1915 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/36/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 11 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 19th Battalion |
| Fate | Returned to Australia 7 June 1918 |