| Regimental number | 5743 |
| Place of birth | Shropshire England |
| Religion | Church of England |
| Occupation | Miner |
| Address | Surry Hills, New South Wales |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs K Green, New Uabba Station, Gargella, New South Wales |
| Enlistment date | 24 April 1916 |
| Rank on enlistment | Sapper |
| Unit name | Tunnelling Companies Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 25 October 1916 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |
