| Regimental number | 6569 |
| Place of birth | Grafton New South Wales |
| Religion | Church of England |
| Occupation | Saddler |
| Address | Bondi Junction, New South Wales |
| Marital status | Married |
| Age at embarkation | 43 |
| Next of kin | Wife, Mrs M A Haynes c/o G Haynes Cowper Street, Bondi Junction, Sydney, New South Wales |
| Enlistment date | 19 January 1917 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/34/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 7 February 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 10 January 1918 |
