| Regimental number | 2404 |
| Place of birth | Merino Victoria |
| Religion | Church of England |
| Occupation | Groom |
| Address | Merino, Victoria |
| Marital status | Single |
| Age at embarkation | 32 |
| Next of kin | Mrs Alice Miller, Merino, Victoria |
| Enlistment date | |
| Rank on enlistment | Private |
| Unit name | 23rd Battalion, 5th Reinforcement |
| AWM Embarkation Roll number | 23/40/2 |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board HMAT RMS Osterley on |
| Rank from Nominal Roll | Corporal |
| Unit from Nominal Roll | 23rd Battalion |
| Recommendations (Medals and Awards) |
Military Medal Recommendation date: |
| Fate | Returned to Australia |
| Date of death | |
| Place of burial | Merino Cemetery |