| Regimental number | 5099 |
| Place of birth | Carcoar New South Wales |
| Religion | Roman Catholic |
| Occupation | Locomotive driver |
| Address | 29 Rockett Street, Bathurst, New South Wales |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Mother, Mrs E Hickey, 29 Rockett Street, Bathurst, New South Wales |
| Enlistment date | 11 November 1915 |
| Rank on enlistment | Private |
| Unit name | 13th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/30/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A16 Star Of Victoria on 31 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Battalion |
| Fate | Returned to Australia 4 May 1917 |
