| Regimental number | 15109 |
| Place of birth | Swansea Tas |
| Religion | Church of England |
| Occupation | Accountant and telegraphist |
| Address | Orrong Road, Burswood, Western Australia |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs Grace Ethel Haynes, 230 James Street, Perth, Western Australia |
| Enlistment date | 11 April 1916 |
| Rank on enlistment | Sapper |
| Unit name | Divisional Signal Company 4, Reinforcement 5 |
| AWM Embarkation Roll number | 22/14/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A52 Surada on 26 September 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Divisional Signal Company |
| Fate | Returned to Australia 1 June 1919 |
