| Regimental number | 6765 |
| Place of birth | Melbourne Vic |
| Religion | Church of England |
| Occupation | Driver |
| Address | South Richmond, Victoria |
| Marital status | Married |
| Age at embarkation | 24 |
| Next of kin | Wife, Mrs Olive Ida Henderson, Bay Street, Port Melbourne, Victoria |
| Enlistment date | 24 February 1917 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/39/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 11 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia 5 November 1917 |
