| Regimental number | 3773 |
| Place of birth | Ballarat Vic |
| Religion | Church of England |
| Occupation | Labourer |
| Marital status | Single |
| Age at embarkation | 43 |
| Next of kin | Friend, Mrs O Ascon, Second Street, Port Pirie, South Australia |
| Enlistment date | 11 August 1915 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/27/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board RMS Malwa on 2 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 13th Field Company Engineers |
| Fate | Returned to Australia 8 April 1917 |
