| Regimental number | 4124 |
| Place of birth | Sydney New South Wales |
| Religion | Roman Catholic |
| Occupation | Blacksmith |
| Address | 80 Bathurst Street, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 42 |
| Next of kin | Sister, Mrs Harriet Belfrage, Mount Morgan, Queensland |
| Enlistment date | 5 April 1917 |
| Rank on enlistment | Private |
| Unit name | 1st Pioneer Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 14/13/5 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 16 June 1917 |