| Regimental number | 1762 |
| Place of birth | Deniliquin New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 12 Byron Street, East Kew, Victoria |
| Marital status | Single |
| Age at embarkation | 38 |
| Next of kin | Mrs S Henry, 12 Byron Street, East Kew, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 4th Reinforcement |
| AWM Embarkation Roll number | 23/21/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A9 Shropshire on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 4th Battalion |
| Fate | Returned to Australia |
| Medals |
Military Medal Source: 'Commonwealth Gazette' No. 169 Date: |
| Other details | Medals: Distinguished Conduct Medal, Military Medal, 1914-15 Star, British War Medal, Victory Medal |