| Regimental number | 1310 |
| Place of birth | Christchurch New Zealand |
| Religion | Church of England |
| Occupation | Station hand |
| Address | Baulkham Hills, Parramatta, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Mother, Mrs Mary Hancock, c/o J Haystead, 8 Brilliant Street, Bathurst, New South Wales |
| Enlistment date | 20 August 1915 |
| Rank on enlistment | Private |
| Unit name | 12th Light Horse Regiment, 7th Reinforcement |
| AWM Embarkation Roll number | 10/17/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Hawkes Bay on 21 October 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st ICO |
| Fate | Returned to Australia 12 November 1917 |
