| Regimental number | 5869 |
| Place of birth | Sydney New South Wales |
| Religion | Church of England |
| Occupation | Miner |
| Address | Golden Grove Hotel Alma Street, Darlington, New South Wales |
| Marital status | Married |
| Age at embarkation | 37 |
| Next of kin | Wife, Mrs Hannah Jane Mason, Goldengrove Hotel Alma Street, Darlington, New South Wales |
| Enlistment date | 29 May 1916 |
| Rank on enlistment | Private |
| Unit name | 17th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/34/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A40 Ceramic on 7 October 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 17th Battalion |
| Fate | Returned to Australia 1 May 1919 |