| Regimental number | 5158 |
| Place of birth | Picton Western Australia |
| Religion | Church of England |
| Occupation | Miner |
| Address | Collie, Western Australia |
| Marital status | Single |
| Age at embarkation | 22 |
| Next of kin | Mother, Mrs R Moore, Collieburn, Western Australia |
| Enlistment date | 8 February 1916 |
| Rank on enlistment | Private |
| Unit name | 11th Battalion, 16th Reinforcement |
| AWM Embarkation Roll number | 23/28/4 |
| Embarkation details | Unit embarked from Fremantle, Western Australia, on board HMAT A9 Shropshire on 31 March 1916 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 11th Battalion |
| Fate | Returned to Australia 4 May 1917 |
