| Regimental number | 6212 |
| Place of birth | Glen Innes New South Wales |
| Religion | Roman Catholic |
| Occupation | Fitter |
| Address | Glen Innes, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Mother, Mrs Julia Jarvis, Judge Street, Petrie Terrace, Queensland |
| Enlistment date | 22 September 1915 |
| Date of enlistment from Nominal Roll | 3 November 1916 |
| Rank on enlistment | Private |
| Unit name | 25th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/42/5 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A75 Marathon on 27 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 25th Battalion |
| Fate | Returned to Australia 27 July 1917 |
