| Regimental number | 39110 |
| Place of birth | Wentworth New South Wales |
| Religion | Methodist |
| Occupation | Clergyman |
| Address | Kellerberrin, Western Australia |
| Marital status | Married |
| Age at embarkation | 32 |
| Next of kin | Wife, Mrs Amelia Jeffreys, c/o Rev J A Jeffreys, Methodist Parsonage, Regent Street, Preston, Victoria |
| Enlistment date | 6 March 1917 |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade, Reinforcement 33 |
| AWM Embarkation Roll number | 13/128/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board SS Indarra on 26 November 1917 |
| Miscellaneous details (Nominal Roll) | Name does not appear on Nominal Roll |