| Regimental number | 6763 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Boilermaker |
| Address | 85 College Street, Balmain, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Friend, Mrs M Jones, 85 College Street, Balmain, Sydney, New South Wales |
| Enlistment date | 3 July 1916 |
| Date of enlistment from Nominal Roll | 28 June 1916 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 22nd Reinforcement |
| AWM Embarkation Roll number | 23/19/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Port Nicholson on 8 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 2nd Battalion |
| Fate | Returned to Australia 26 September 1917 |