| Regimental number | 1058 |
| Place of birth | Adelaide South Australia |
| Religion | Church of England |
| Occupation | Moulder |
| Address | ... |
| Marital status | Single |
| Age at embarkation | 20 |
| Next of kin | ..., Lizzie Lodge, Kilkenny, South Australia |
| Enlistment date | 21 January 1915 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, F Company |
| AWM Embarkation Roll number | 23/33/1 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board Troopship A40 Ceramic on 22 June 1915 |
| Rank from Nominal Roll | Driver |
| Unit from Nominal Roll | 11th Field Artillery Brigade |
| Fate | Returned to Australia 8 December 1917 |
