| Regimental number | 6822 |
| Place of birth | Newtown New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Erskineville, New South Wales |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, NSW Mrs Elizabeth Jackson, North Parade, Granville, New South Wales |
| Enlistment date | 30 April 1917 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/34/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 16 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 8 January 1919 |