| Regimental number | 5364 |
| Place of birth | Lithgow New South Wales |
| Religion | Church of England |
| Occupation | Shop assistant |
| Address | Waratah, Street, Lithgow, New South Wales |
| Marital status | Single |
| Age at embarkation | 21 |
| Next of kin | Mother, Mrs Janet Martyn, Waratah, Street, Lithgow, New South Wales |
| Previous military service | 41st Infantry |
| Enlistment date | 27 January 1916 |
| Rank on enlistment | Private |
| Unit name | 19th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/36/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A18 Wiltshire on 22 August 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Ordnance Corps |
| Fate | Returned to Australia 28 August 1919 |
