| Regimental number | 4365 |
| Place of birth | Grimsby ENGLAND |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 'Roslyn', via Goulburn, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs M Gibbett, 44 Breraton Avenue, Grimsby, England |
| Previous military service | 43rd Infantry |
| Enlistment date | 25 October 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Port Napier on 17 November 1916 |
| Regimental number from Nominal Roll | 4365A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 35th Battalion |
| Fate | Returned to Australia 12 June 1919 |