| Regimental number | 2012 |
| Place of birth | Tatham New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Tatham via Casino, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Sister, Mrs H Fuller, Tatham via Casino, Richmond River, New South Wales |
| Enlistment date | 14 June 1917 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company June 1917, General Reinforcements |
| AWM Embarkation Roll number | 24/36/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board SS Indarra on 26 November 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Machine Gun Battalion |
| Fate | Returned to Australia 5 July 1919 |
