| Regimental number | 1965 |
| Place of birth | Newport Victoria |
| Religion | Roman Catholic |
| Occupation | Quarryman |
| Address | Newport, Victoria |
| Marital status | Single |
| Age at embarkation | 41 |
| Next of kin | Sister, Mrs Mary Jane Bliss, 380 Melbourne Road, Newport, Victoria |
| Enlistment date | 11 March 1916 |
| Date of enlistment from Nominal Roll | 4 April 1916 |
| Rank on enlistment | Private |
| Unit name | 46th Battalion, 3rd Reinforcement |
| AWM Embarkation Roll number | 23/63/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A30 Borda on 5 June 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 46th Battalion |
| Fate | Returned to Australia 8 April 1917 |
