| Regimental number | 4037 |
| Place of birth | Walcha New South Wales |
| Religion | Roman Catholic |
| Occupation | Blacksmith |
| Address | Manilla, New South Wales |
| Marital status | Single |
| Age at embarkation | 36 |
| Next of kin | Sister, Mrs G Taylor, Geelong Public School, New South Wales |
| Enlistment date | 29 August 1915 |
| Rank on enlistment | Private |
| Unit name | 4th Battalion, 12th Reinforcement |
| AWM Embarkation Roll number | 23/21/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A7 Medic on 30 December 1915 |
| Rank from Nominal Roll | Private |
| Fate | Returned to Australia 30 January 1918 |
| Miscellaneous details (Nominal Roll) | Army Medical Corps |
| Other details | Medals: British War Medal, Victory Medal |
