| Regimental number | 5396 |
| Place of birth | Esk Queensland |
| Religion | Church of England |
| Occupation | Telegraphist |
| Address | Burnam, Crows Nest Line, Queensland |
| Marital status | Married |
| Age at embarkation | 40 |
| Next of kin | Wife, Mrs E Jenner, Burnam Crows Nest Line, Queensland |
| Enlistment date | 24 September 1914 |
| Rank on enlistment | Private |
| Unit name | 9th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/26/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Hawkes Bay on 20 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Medical Corps |
| Fate | Returned to Australia 5 March 1919 |