| Regimental number | 3706 |
| Place of birth | Victor Harbor South Australia |
| Religion | Church of England |
| Occupation | Salesman |
| Address | Tumby Bay, South Australia |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs M Ann Jeffery, Tumby Bay, South Australia |
| Enlistment date | 3 August 1915 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board RMS Malwa on 2 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 1st Field Ambulance |
| Fate | Returned to Australia 8 May 1919 |