| Regimental number | 2819 |
| Place of birth | Candelo New South Wales |
| Religion | Church of England |
| Occupation | Baker |
| Address | PO, Candelo, New South Wales |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Selina Hazelgrove, PO, Candelo, New South Wales |
| Enlistment date | 20 January 1916 |
| Rank on enlistment | Private |
| Unit name | 7th Light Horse Regiment, 19th Reinforcement |
| AWM Embarkation Roll number | 10/12/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board RMS Mongolia on 8 July 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 7th Light Horse Regiment |
| Fate | Returned to Australia 15 March 1919 |
