| Regimental number | 18636 |
| Place of birth | Ballarat Victoria |
| Religion | Church of England |
| Occupation | Compositor |
| Address | Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs Beatrice May Haisman, 'Ladore,' Corona ave., Waverley, New South Wales |
| Enlistment date | 19 February 1917 |
| Rank on enlistment | Sapper |
| Unit name | May 1917 Reinforcements |
| AWM Embarkation Roll number | 14/42/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 8 August 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 7th Field Company Engineers |
| Fate | Returned to Australia 1 April 1919 |
