| Regimental number | 3628 |
| Place of birth | Llandinam Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | 59 Charles Street, Erskineville, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 40 |
| Next of kin | Sister, Maggie Kinsey, Montgomery, North Wales |
| Enlistment date | 13 November 1915 |
| Rank on enlistment | Sapper |
| Unit name | Tunnelling Company 4, Headquarters 1 |
| AWM Embarkation Roll number | 16/10/1 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A69 Warilda on 22 May 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 1st Tunnelling Company |
| Fate | Returned to Australia 20 April 1919 |
