| Regimental number | 3004 |
| Place of birth | Melbourne, Victoria |
| Religion | Methodist |
| Occupation | Butcher |
| Address | Darton Street, Sandwell, South Australia |
| Marital status | Single |
| Age at embarkation | 25 |
| Next of kin | Mother, Mrs S Beaumont, Darton Street, Sandwell Port, Adelaide, South Australia |
| Enlistment date | 16 June 1915 |
| Rank on enlistment | Private |
| Unit name | 16th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/33/3 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A70 Ballarat on 14 September 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 16th Battalion |
| Fate | Returned to Australia 1 May 1919 |
