| Regimental number | 2621 |
| Place of birth | Ballarat Victoria |
| Religion | Church of England |
| Occupation | Smithy |
| Address | Adelaide, South Australia |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs May Haines, 69 Wright Street, Adelaide, South Australia |
| Enlistment date | 5 August 1916 |
| Rank on enlistment | Private |
| Unit name | 5th Pioneer Battalion, Reinforcement 5 |
| AWM Embarkation Roll number | 14/17/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A73 Commonwealth on 21 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 5th Pioneer Battalion |
| Fate | Returned to Australia 6 December 1916 |
