| Regimental number | 4056 |
| Place of birth | Redfern New South Wales |
| Religion | Church of England |
| Occupation | Brushmaker |
| Address | ... |
| Marital status | Single |
| Age at embarkation | 30 |
| Next of kin | Mother, Mrs H Johnson, 7 Cannington Street, Summer Hill, Sydney, New South Wales |
| Enlistment date | 11 August 1915 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/28/3 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board RMS Mongolia on 22 November 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 51st Battalion |
| Fate | Returned to Australia 20 December 1918 |