| Regimental number | 4650 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Baker |
| Address | 19 Howard Street, West Melbourne, Victoria |
| Marital status | Married |
| Age at embarkation | 36 |
| Next of kin | Wife, Mrs Alic Johnson, 19 Howard Street, West Melbourne, Victoria |
| Enlistment date | 30 August 1916 |
| Rank on enlistment | Private |
| Unit name | 29th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/46/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A7 Medic on 16 December 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 29th Battalion |
| Fate | Returned to Australia 11 January 1918 |
