| Regimental number | 6803 |
| Place of birth | Abbotsford Victoria |
| Religion | Church of England |
| Occupation | Bootmaker |
| Address | St Kilda, Victoria |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Nie, Miss Edith Mary Tapner, 'Arundel', Kendall Street, St Kilda, Victoria |
| Enlistment date | 17 February 1917 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/39/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 11 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia 31 January 1918 |
