| Regimental number | 3790 |
| Place of birth | Bendigo Vic |
| Occupation | Baker |
| Address | 58 Greville Street, Prahran, Victoria |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Mother, Mrs M A Haynes, 58 Greville Street, Prahran, Victoria |
| Enlistment date | 21 July 1915 |
| Rank on enlistment | Private |
| Unit name | 6th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/23/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A40 Ceramic on 23 November 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 6th Battalion |
| Fate | Returned to Australia 27 September 1917 |
