| Regimental number | 4341 |
| Place of birth | Holywell, Wales |
| Religion | Church of England |
| Occupation | Fencer and miner |
| Address | Granville, Sydney, New South Wales |
| Marital status | Married |
| Age at embarkation | 44 |
| Next of kin | Wife, Mrs Ada Bellis, Trongate Street, Granville, Sydney, New South Wales |
| Enlistment date | 26 September 1916 |
| Place of enlistment | Sydney, New South Wales |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 11th Reinforcement |
| AWM Embarkation Roll number | 23/47/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT SS Port Napier on 17 November 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 30th Battalion |
| Fate | Returned to Australia 11 January 1918 |