| Regimental number | 26696 |
| Place of birth | Maryborough Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Bung Bong PO, Bung Bong via Maryborough, Victoria |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Mother, Mrs E Jose, Bung Bong PO, Bung Bong via Maryborough, Victoria |
| Enlistment date | |
| Rank on enlistment | Gunner |
| Unit name | Field Artillery Brigade 12, Reinforcement 5 |
| AWM Embarkation Roll number | 13/39/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A15 Port Sydney on |
| Rank from Nominal Roll | Gunner |
| Unit from Nominal Roll | 12th Field Artillery Brigade |
| Fate | Returned to Australia |
| Other details |
War service: Western Front Medals: British War Medal, Victory Medal |