| Regimental number | 3004 |
| Place of birth | Stockton on Tees England |
| Religion | Church of England |
| Occupation | Carpenter |
| Address | 267 Lennox Street, Richmond, Victoria |
| Marital status | Married |
| Age at embarkation | 38 |
| Next of kin | Wife, Mrs H Bellas, 267 Lennox Street, Richmond, Victoria |
| Enlistment date | 13 July 1915 |
| Rank on enlistment | Private |
| Unit name | 7th Battalion, 10th Reinforcement |
| AWM Embarkation Roll number | 23/24/3 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT RMS Osterley on 29 September 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | Australian Employment Company |
| Fate | Returned to Australia 24 August 1918 |
