| Regimental number | 6491 |
| Place of birth | Tenterfield New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Glenreagh, New South Wales |
| Marital status | Single |
| Age at embarkation | 29 |
| Next of kin | Mother, Mrs E Holder, Lionsville, Clarence River, New South Wales |
| Enlistment date | 27 June 1916 |
| Rank on enlistment | Private |
| Unit name | 9th Battalion, 21st Reinforcement |
| AWM Embarkation Roll number | 23/26/4 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A36 Boonah on 21 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 9th Battalion |
| Fate | Returned to Australia 27 August 1917 |
