| Regimental number | 2964 |
| Religion | No religion |
| Occupation | Labourer |
| Address | Brisbane, Queensland |
| Marital status | Single |
| Age at embarkation | 44 |
| Next of kin | Step-Mother, Mrs Alice Grigg, 72 Western Street, Swansea, South Wales |
| Enlistment date | 1 April 1916 |
| Rank on enlistment | Private |
| Unit name | 5th Light Horse Regiment, 21st Reinforcement |
| AWM Embarkation Roll number | 10/10/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A58 Kabinga on 12 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Light Horse Regiment |
| Fate | Returned to Australia 12 November 1917 |
