| Regimental number | 17564 |
| Place of birth | Leichhardt New South Wales |
| Religion | Methodist |
| Occupation | Mill hand |
| Address | Callan Park, Sydney, New South Wales |
| Marital status | Single |
| Age at embarkation | 18 |
| Next of kin | Mother, Mrs E Monk, c/o Hospital, Callan Park, Sydney, New South Wales |
| Previous military service | 31st Infantry |
| Enlistment date | 18 March 1916 |
| Date of enlistment from Nominal Roll | 4 March 1916 |
| Rank on enlistment | Private |
| Unit name | April 1917 Reinforcements |
| AWM Embarkation Roll number | 26/99/2 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A20 Hororata on 14 June 1917 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Australian General Hospital |
| Fate | Returned to Australia 23 June 1919 |
