| Regimental number | 39A |
| Place of birth | Brisbane Queensland |
| Religion | Church of England |
| Occupation | Telephone fitter |
| Address | Hobart, Tasmania |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs L Jacobs, 39 Bathurst Road, Hobart, Tasmania |
| Enlistment date | 27 April 1915 |
| Rank on enlistment | Private |
| Unit name | No 1 Australian General Hospital |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board A62 Wandilla on 25 June 1915 |
| Regimental number from Nominal Roll | 39 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Australian General Hospital |
| Fate | Returned to Australia 15 August 1915 |