| Regimental number | 2309 |
| Place of birth | Monaro New South Wales |
| Religion | Church of England |
| Occupation | Wheeler |
| Address | Greta, New South Wales |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Sister, Mrs Amy Tillott, Enfield PO, Enfield, New South Wales |
| Enlistment date | 5 March 1917 |
| Rank on enlistment | Private |
| Unit name | 12th Light Horse Regiment, 18th Reinforcement |
| AWM Embarkation Roll number | 10/17/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A15 Port Sydney on 9 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Light Horse Regiment |
| Fate | Returned to Australia 16 March 1919 |