| Regimental number | 2569A |
| Place of birth | Reedy Creek, Victoria |
| Religion | Church of England |
| Occupation | Miner |
| Address | Reedy Creek, Victoria |
| Marital status | Married |
| Age at embarkation | 31 |
| Next of kin | Wife, Mrs Olive Jane Balmer, Broadford, Victoria |
| Enlistment date | 20 September 1917 |
| Rank on enlistment | Private |
| Unit name | 13th Light Horse Regiment, 22nd Reinforcement |
| AWM Embarkation Roll number | 10/18/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A38 Ulysses on 22 December 1917 |
| Regimental number from Nominal Roll | 3987 |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | Artillery Details |
| Fate | Returned to Australia 17 March 1919 |
