| Regimental number | 4758 |
| Place of birth | Horsham Victoria |
| Religion | Church of England |
| Occupation | Horse driver |
| Address | West Leederville, Western Australia |
| Marital status | Married |
| Age at embarkation | 23 |
| Next of kin | Wife, Mrs Gertrude Jarvis, 5 Bruce Street, West Leederville, Western Australia |
| Enlistment date | 1 March 1916 |
| Date of enlistment from Nominal Roll | 27 February 1916 |
| Rank on enlistment | Private |
| Unit name | 28th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/45/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A60 Aeneas on 17 April 1916 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 28th Battalion |
| Fate | Returned to Australia 3 March 1919 |
