| Regimental number | 4200 |
| Place of birth | Cobargo New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Bermagui, South Coast, New South Wales |
| Marital status | Single |
| Age at embarkation | 33 |
| Next of kin | Mrs. E. Horne, Bermagui, South Coast, New South Wales |
| Enlistment date | 7 September 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/21/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A60 Aeneas on 20 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Battalion |
| Fate | Returned to Australia 13 February 1917 |
