| Regimental number | 5403 |
| Place of birth | Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Bowen, Queensland |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs N Jones, PO, Proserpine, Queensland |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/29/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board SS Hawkes Bay on |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 12th Battalion |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |