| Regimental number | 5121 |
| Place of birth | Clunes Tasmania |
| Religion | Church of England |
| Occupation | Painter |
| Address | Ulverstone, Tasmania |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs J Jordan, Ulverstone, Tasmania |
| Enlistment date | 6 January 1916 |
| Date of enlistment from Nominal Roll | 7 January 1916 |
| Rank on enlistment | Private |
| Unit name | 12th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/29/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board RMS Orontes on 29 March 1916 |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 51st Battalion |
| Fate | Returned to Australia 12 May 1919 |
