| Regimental number | 6773 |
| Place of birth | Melbourne, Victoria |
| Religion | Church of England |
| Occupation | Driver |
| Address | North Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs Minnie Ballem, 112 Holden Street, North Fitzroy, Victoria |
| Enlistment date | 26 January 1917 |
| Date of enlistment from Nominal Roll | 26 January 1917 |
| Rank on enlistment | Private |
| Unit name | 23rd Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/40/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 11 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 23rd Battalion |
| Fate | Returned to Australia 10 March 1918 |
