| Regimental number | 4124 |
| Place of birth | London England |
| Religion | Church of England |
| Occupation | Labourer |
| Marital status | Married |
| Age at embarkation | 39 |
| Next of kin | Wife, Mrs Amy Keeley, 9 Mahoney Street, North Richmond, Melbourne, Victoria |
| Enlistment date | 11 August 1915 |
| Rank on enlistment | Private |
| Unit name | 23rd Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/49/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A18 Wiltshire on 7 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 67th Battalion |
| Fate | Returned to Australia 27 July 1917 |
