| Regimental number | 621 |
| Place of birth | Carlton Victoria |
| Religion | Roman Catholic |
| Occupation | Shop assistant |
| Address | 115 George Street, Fitzroy, Victoria |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Mrs L Johnson, 115 George Street, Fitzroy, Victoria |
| Enlistment date | 23 September 1914 |
| Rank on enlistment | Private |
| Unit name | 1st Field Ambulance, Reinforcement 1 |
| AWM Embarkation Roll number | 26/44/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A35 Berrima on 22 December 1914 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Light Horse Field Ambulance |
| Fate | Returned to Australia 16 January 1919 |
