| Regimental number | 4491 |
| Place of birth | Muttama New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Mittammar, New South Wales |
| Marital status | Single |
| Age at embarkation | 24 |
| Next of kin | Mother, Mrs Mary Ann Beasley, Mittammar, New South Wales |
| Enlistment date | 29 October 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 25 November 1916 |
| Fate | No details of fate entered on Nominal Roll |