| Regimental number | 5022 |
| Place of birth | Lithgow New South Wales |
| Religion | Church of England |
| Occupation | Engine driver |
| Address | Vale of Clwydd, Lithgow, New South Wales |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs S Grace, Vale of Clwydd, Lithgow, New South Wales |
| Enlistment date | 21 December 1915 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A55 Kyarra on 5 June 1916 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 5th Light Trench Mortar Battery |
| Fate | Returned to Australia 22 December 1918 |
