| Regimental number | 5379 |
| Place of birth | Wayo New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Sapling Creek, Laggan PO via Crookwell, New South Wales |
| Marital status | Single |
| Age at embarkation | 38 |
| Next of kin | Mother, Mrs E Gray, Sapling Creek, Laggan PO via Crookwell, New South Wales |
| Enlistment date | 15 December 1915 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on 9 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 45th Battalion |
| Fate | Returned to Australia 17 March 1917 |