| Regimental number | 4204 |
| Place of birth | Warrnambool Vic |
| Religion | Church of England |
| Occupation | Cork cutter |
| Address | Fitzroy Road, Warrnambool, Victoria |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Father, Mr R Henderson, Fitzroy Road, Warrnambool, Victoria |
| Enlistment date | 22 July 1915 |
| Rank on enlistment | Private |
| Unit name | 7th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/24/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A64 Demosthenes on 29 December 1915 |
| Rank from Nominal Roll | Sergeant |
| Unit from Nominal Roll | 1st Pioneer Battalion |
| Fate | Returned to Australia 31 March 1919 |
