| Regimental number | 6391A |
| Place of birth | Geraldton Western Australia |
| Religion | Wesleyan |
| Occupation | Cordial manufacturer |
| Address | 6 Bulwet Street, North Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 37 |
| Next of kin | Mother, Mrs W Jose, 6 Bulwet Street, North Perth, Western Australia |
| Enlistment date | 19 December 1915 |
| Rank on enlistment | Private |
| Unit name | Divisional Train 2,Army Service Corps 16, Reinforcement 11 |
| AWM Embarkation Roll number | 25/15/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A71 Nestor on 9 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Service Corps |
| Fate | Returned to Australia 1 November 1917 |
