| Regimental number | 6936 |
| Place of birth | Waterloo New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | Parramatta, New South Wales |
| Marital status | Married |
| Age at embarkation | 45 |
| Next of kin | Wife, Mrs Lilian Jackson Maxwell, Hospital For Insane, Parramatta, New South Wales |
| Enlistment date | 13 May 1917 |
| Rank on enlistment | Private |
| Unit name | 18th Battalion, 20th Reinforcement |
| AWM Embarkation Roll number | 23/35/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A72 Beltana on 16 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 18th Battalion |
| Fate | Returned to Australia 1 November 1917 |
