| Regimental number | 3804 |
| Place of birth | Worcester, England |
| Religion | Church of England |
| Occupation | Cook |
| Address | Australian Hotel, St George, Queensland |
| Marital status | Single |
| Age at embarkation | 33 |
| Height | 5' 2.5" |
| Weight | 121.5 lbs |
| Next of kin | Friend, George Cousins, Australian Hotel, St George, Queensland |
| Previous military service | Nil |
| Enlistment date | 2 April 1916 |
| Date of enlistment from Nominal Roll | "`" |
| Place of enlistment | Warwick, Queensland |
| Rank on enlistment | Private |
| Unit name | 4th Pioneer Battalion, Reinforcement 10 |
| AWM Embarkation Roll number | 14/16/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on 13 June 1917 |
| Rank from Nominal Roll | Lance Corporal |
| Unit from Nominal Roll | Australian Infantry Base Depot |
| Fate | Returned to Australia 20 December 1919 |
| Discharge date | 20 March 1920 |
| Other details | Medals: British War Medal, Victory Medal |
