| Regimental number | 17039 |
| Place of birth | Hay New South Wales |
| Religion | Church of England |
| Occupation | Bookkeeper |
| Address | Narrandera, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs C Hayward, Charles Street, Narrandera, New South Wales |
| Enlistment date | 21 March 1916 |
| Rank on enlistment | Private |
| Unit name | Army Medical Corps February 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A9 Shropshire on 11 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Field Ambulance |
| Fate | Effective abroad (still overseas) |