| Regimental number | 4136 |
| Place of birth | Moree New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Ellen Road, Auburn, New South Wales |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs A Heath, Ellen Road, Auburn, New South Wales |
| Enlistment date | 28 August 1915 |
| Rank on enlistment | Acting Corporal |
| Unit name | 19th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/36/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A67 Orsova on 11 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 19th Battalion |
| Fate | Returned to Australia 5 April 1917 |
