| Regimental number | 54209 |
| Place of birth | Cobargo New South Wales |
| Religion | Roman Catholic |
| Occupation | Farmer |
| Address | Cobargo, New South Wales |
| Marital status | Single |
| Age at embarkation | 36 |
| Next of kin | Mother, Mrs B Henry, Cobargo, New South Wales |
| Enlistment date | 14 March 1918 |
| Rank on enlistment | Private |
| Unit name | 6th General Service Reinforcements (New South Wales) |
| AWM Embarkation Roll number | 23/111/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Feldmarschall on 19 June 1918 |
| Rank from Nominal Roll | Bombardier |
| Unit from Nominal Roll | Artillery Details |
| Fate | Returned to Australia 22 July 1919 |
