| Regimental number | 5421 |
| Place of birth | Charters Towers Queensland |
| Occupation | Boilermakers assistant |
| Address | C/- Colter and Addes Street, Kalgoorlie, Western Australia |
| Marital status | Single |
| Age at embarkation | 28 |
| Next of kin | Mother, Mrs M G Jowett, Corner Colter and Addes Streets, Kalgoorlie, Western Australia |
| Enlistment date | 12 January 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 17th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A60 Aeneas on 17 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 18 December 1918 |
