| Regimental number | 3504 |
| Place of birth | Norfolk, England |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Balmain, New South Wales |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Frances Jones, 1 Clay Street, Balmain, New South Wales |
| Enlistment date | 9 January 1917 |
| Place of enlistment | Sydney, New South Wales |
| Rank on enlistment | Private |
| Unit name | 45th Battalion, 9th Reinforcement |
| AWM Embarkation Roll number | 23/62/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 24 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 45th Battalion |
| Fate | Returned to Australia 30 January 1918 |