| Regimental number | 4119 |
| Religion | Methodist |
| Occupation | Carriage builder |
| Address | Trongate Street, Granville, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, Samuel Jeffery, Trongate Street, Granville, Sydney, New South Wales |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 1st Pioneer Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 14/13/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on |