| Regimental number | 17682 |
| Place of birth | Adelaide, South Australia |
| Religion | Church of England |
| Occupation | Clerk |
| Address | Gawler, South Australia |
| Marital status | Single |
| Age at embarkation | 35 |
| Next of kin | Mother, Mrs E Beadnall, Gawler, South Australia |
| Enlistment date | 24 October 1916 |
| Rank on enlistment | Private |
| Unit name | April 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A16 Port Melbourne on 16 July 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Field Ambulance |
| Fate | Returned to Australia 12 July 1919 |