| Regimental number | 4639 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Engineer |
| Address | 17 Mort Street, Moore Park, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, T Haywood, 17 Mort Street, Moore Park, Surry Hills, Sydney, New South Wales |
| Enlistment date | 15 August 1915 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Osterley on 15 January 1916 |
| Fate | No details of fate entered on Nominal Roll |
