| Regimental number | 873 |
| Place of birth | Streaky Bay South Australia |
| Religion | Baptist |
| Occupation | Farm hand |
| Address | High Street, Burnside, South Australia |
| Marital status | Single |
| Age at embarkation | 19 |
| Next of kin | Father, J. Mortimer, High Street, Burnside, South Australia |
| Enlistment date | 8 December 1914 |
| Rank on enlistment | Private |
| Unit name | 3rd Light Horse Regiment, 4th Reinforcement |
| AWM Embarkation Roll number | 10/8/2 |
| Embarkation details | Unit embarked from Adelaide, South Australia, on board HMAT A17 Port Lincoln on 1 April 1915 |
| Rank from Nominal Roll | Private |
| Unit from Nominal Roll | 3rd Light Horse Regiment |
| Fate | Returned to Australia 28 January 1919 |
