| Regimental number | 6802 |
| Place of birth | Geelong, Victoria |
| Religion | Church of England |
| Occupation | Labourer |
| Address | Chilwell, Victoria |
| Marital status | Married |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs Elizabeth Beales, 18 Nicholas Street, Chilwell, Geelong, Victoria |
| Enlistment date | 28 November 1916 |
| Rank on enlistment | Private |
| Unit name | 22nd Battalion, 19th Reinforcement |
| AWM Embarkation Roll number | 23/39/5 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT A11 Ascanius on 11 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 22nd Battalion |
| Fate | Returned to Australia 31 October 1917 |