| Regimental number | 30906 |
| Place of birth | London, England |
| Religion | Church of England |
| Occupation | Carter |
| Address | 'Orient', French Street, Kogarah, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 29 |
| Next of kin | Wife, Mrs B L Bastin, French Street, Kogarah, Sydney, New South Wales |
| Enlistment date | 6 September 1916 |
| Place of enlistment | Sydney, New South Wales |
| Rank on enlistment | Gunner |
| Unit name | Medium Trench Mortar Battery Reinforcement 4 |
| AWM Embarkation Roll number | 13/129/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A29 Suevic on 11 November 1916 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 4th Division Ammunition Column |
| Fate | Returned to Australia 11 December 1918 |
