| Regimental number | 10921 |
| Place of birth | Adelaide, South Australia |
| Religion | Roman Catholic |
| Occupation | Dentistry |
| Address | North Perth, Western Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs R M Bennett, 293 Bulwer Street, North Perth, Western Australia |
| Enlistment date | 29 February 1916 |
| Date of enlistment from Nominal Roll | 29 January 1916 |
| Rank on enlistment | Staff Sergeant |
| Unit name | Dental Details |
| AWM Embarkation Roll number | 26/105/1 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A48 Seang Bee on 18 July 1916 |
| Rank from Nominal Roll | Staff Sergeant |
| Unit from Nominal Roll | Dental Corps |
| Fate | Returned to Australia 27 May 1919 |
