| Regimental number | 5136 |
| Place of birth | Pyrmont New South Wales |
| Religion | Church of England |
| Occupation | Machinist |
| Address | Campsie, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Father, James Frederick Maxworthy, Beamish Street, Campsie, New South Wales |
| Enlistment date | 16 March 1917 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 14th Reinforcement |
| AWM Embarkation Roll number | 23/47/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A74 Marathon on 10 May 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Army Veterinary Hospital |
| Fate | Returned to Australia 31 July 1918 |
