| Regimental number | 4213 |
| Place of birth | Walgett New South Wales |
| Religion | Church of England |
| Occupation | Labourer |
| Address | c/o N Prendergast, Whitton, New South Wales |
| Marital status | Married |
| Age at embarkation | 31 |
| Next of kin | Wife, Mrs R Montgomery, Joshua Street Goulburn, New South Wales |
| Enlistment date | 8 September 1915 |
| Rank on enlistment | Private |
| Unit name | 2nd Battalion, 13th Reinforcement |
| AWM Embarkation Roll number | 23/19/3 |
| Embarkation details | Unit embarked from Sydney, New South Wales, on board HMAT A6 Aeneas on 20 December 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 56th Battalion |
| Fate | Returned to Australia 13 April 1919 |