| Regimental number | 5627 |
| Place of birth | Melbourne Victoria |
| Religion | Church of England |
| Occupation | Horticulturist |
| Address | Koorloong Avenue, Irymple, Victoria |
| Marital status | Married |
| Age at embarkation | 30 |
| Next of kin | Wife, Mrs Emily Louisa Lane, 17th St Ettiwanda Avenue, Mildura, Victoria |
| Enlistment date | 21 March 1916 |
| Rank on enlistment | Private |
| Unit name | 23rd Battalion, 15th Reinforcement |
| AWM Embarkation Roll number | 23/40/4 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A9 Shropshire on 25 September 1916 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 6th Broad Gauge Railway Operating Company |
| Fate | Returned to Australia 25 March 1919 |
