| Regimental number | 3213A |
| Place of birth | Warrnambool Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o Mrs A Jewell, c/o Mrs J Lyons, 119 Hansonstreet, Adelaide, South Australia |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs A Jewell, c/o Mrs J Lyons, 119 Hanson Stret, Adelaide, South Australia |
| Enlistment date | 18 July 1915 |
| Rank on enlistment | Private |
| Unit name | 10th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/27/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A70 Ballarat on 14 September 1915 |
| Regimental number from Nominal Roll | 3213 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Battalion |
| Fate | Returned to Australia 5 December 1915 |