| Regimental number | 6124 |
| Place of birth | Breconshire South Wales |
| Religion | Church of England |
| Occupation | Miner |
| Address | Clifton, New South Wales |
| Marital status | Single |
| Age at embarkation | 39 |
| Next of kin | Sister, Mrs R. Brown, Beaufort, Breconshire, England |
| Enlistment date | 28 November 1915 |
| Date of enlistment from Nominal Roll | 23 November 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 22 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia 22 July 1917 |
