| Regimental number | 3777 |
| Place of birth | Alberton South Australia |
| Religion | Church of England |
| Occupation | Solderer |
| Address | c/o Mrs E Cooper, Martin Street, Birkenhead, South Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Sister, Mrs O Hagan, Peterhead, South Australia |
| Enlistment date | 9 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 | 10th Battalion |
| Fate | Returned to Australia 17 October 1916 |
