| Regimental number | 4129 |
| Place of birth | Ewell England |
| Religion | Church of England |
| Occupation | Shoemaker |
| Address | Banyo, Sandgate Line, Queensland |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs E Bates, Banyo, Sandgate Line, Queensland |
| Enlistment date | 3 September 1915 |
| Rank on enlistment | Private |
| Unit name | 15th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/32/2 |
| Embarkation details | Unit embarked from Brisbane, Queensland, on board HMAT A55 Kyarra on 3 January 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 45th Battalion |
| Fate | Returned to Australia 18 January 1919 |
