| Regimental number | 6113 |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Walker Street, North Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 27 |
| Next of kin | Mother, Mrs Annie Hollis, 'Roseville', May Street, East Goulburn, New South Wales |
| Enlistment date | 30 June 1916 |
| Rank on enlistment | Private |
| Unit name | 20th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/37/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A11 Ascanius on 25 October 1916 |
| Fate | No details of fate entered on Nominal Roll |