| Regimental number | 4830 |
| Place of birth | Horsham Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | George Street, East Fremantle, Western Australia |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs J Jarvis, George Street, East Fremantle, Western Australia |
| Enlistment date | 7 December 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A38 Ulysses on 1 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 51st Battalion |
| Fate | Returned to Australia 13 April 1919 |
