| Regimental number | 4817 |
| Religion | Church of England |
| Occupation | Farm labourer |
| Address | Shell Harbor, New South Wales |
| Marital status | Single |
| Age at embarkation | 23 |
| Next of kin | Friend, J Couch, Albion Park, South Coast, New South Wales |
| Enlistment date | 28 November 1916 |
| Rank on enlistment | Private |
| Unit name | 30th Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/47/4 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A68 Anchises on 24 January 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 20th Depot Unit of Supply |
| Fate | Returned to Australia 9 December 1918 |
