| Regimental number | 4771 |
| Place of birth | Tamworth New South Wales |
| Religion | Church of England |
| Occupation | Bricklayer |
| Address | Cohen Street, Tamworth, New South Wales |
| Marital status | Married |
| Age at embarkation | 28 |
| Next of kin | Wife, Mrs M Martin, Cohen Street, Tamworth, New South Wales |
| Enlistment date | 21 January 1916 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/34/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 13 April 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 27 September 1917 |
