| Regimental number | 6393 |
| Place of birth | Christchurch New Zealand |
| Religion | Church of England |
| Occupation | Carpenter |
| Address | Parke Road, Cabramatta, New South Wales |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs A Jacques, Parke Road, Cabramatta, New South Wales |
| Enlistment date | 6 March 1916 |
| Rank on enlistment | Private |
| Unit name | 3rd Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/20/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A14 Euripides on 9 September 1916 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 3rd Battalion |
| Fate | Returned to Australia 30 January 1918 |
