| Regimental number | 16754 |
| Place of birth | Gateshead England |
| Religion | Church of England |
| Occupation | Cleaner, S A R |
| Address | Prospect, South Australia |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs C Bates, 437 Shields Road, Heaton, Newcastle-on-Tyne, England |
| Enlistment date | 10 June 1916 |
| Rank on enlistment | Private |
| Unit name | January 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A48 Seang Bee on 10 February 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 10th Field Ambulance |
| Fate | Returned to Australia 14 December 1918 |
