| Regimental number | 509 |
| Place of birth | Bald Hills Queensland |
| Religion | Methodist |
| Occupation | Farmer |
| Address | Glen Alice, Gayndah, Queensland |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs Marie Jensine Lacey, Glen Alice, Gayndah, Queensland |
| Enlistment date | 17 August 1916 |
| Rank on enlistment | Private |
| Unit name | Machine Gun Company 11, Reinforcement 7 |
| AWM Embarkation Roll number | 24/16/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A70 Ballarat on 19 February 1917 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 1st Machine Gun Battalion |
| Fate | Returned to Australia 12 June 1919 |
