| Regimental number | 2136 |
| Place of birth | Ebbw Vale Wales |
| Religion | Church of England |
| Occupation | Engine driver |
| Address | Wademere, via Wentworthville, New South Wales |
| Marital status | Single |
| Age at embarkation | 34 |
| Next of kin | Aunt, Mrs Silvia Bow, PO, Wademare, Wentworthville, New South Wales |
| Enlistment date | 23 May 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 6th Reinforcement |
| AWM Embarkation Roll number | 23/20/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A63 Karoola on 16 June 1915 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia 25 August 1919 |
