| Regimental number | *21058 |
| Religion | Roman Catholic |
| Occupation | Plumber |
| Address | Sutherland, New South Wales |
| Marital status | Married |
| Age at embarkation | 42 |
| Next of kin | Wife, Mrs M E Hayes, 'Guymea', Bay Road, Sutherland, New South Wales |
| Enlistment date | 23 September 1918 |
| Date of enlistment from Nominal Roll | 11 April 1915 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps, Sea Transport Staff, Section 10 (Mental) |
| AWM Embarkation Roll number | 26/104/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 2 November 1918 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Sea Transport Staff |
| Fate | Returned to Australia 28 March 1919 |