| Regimental number | 6826 |
| Place of birth | Bendigo Victoria |
| Religion | Methodist |
| Occupation | Hatter |
| Address | West Leederville, Western Australia |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs Elizabeth White Grose, 39 McCourt Street, West Leederville, Western Australia |
| Enlistment date | 23 February 1917 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/45/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A30 Borda on 29 June 1917 |
| Regimental number from Nominal Roll | 6826A |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia 9 August 1919 |