| Regimental number | 8124 |
| Place of birth | Crookwell New South Wales |
| Religion | Roman Catholic |
| Occupation | Labourer |
| Address | North Lismore, New South Wales |
| Marital status | Married |
| Age at embarkation | 35 |
| Next of kin | Wife, Mrs C A Mortimer, c/o Mrs J Funnell, North Lismore, New South Wales |
| Enlistment date | 20 August 1917 |
| Rank on enlistment | Sapper |
| Unit name | Tunnelling Companies (September 1916-February 1918): June 1917 Reinforcements |
| Embarkation details | Unit embarked from Melbourne, Victoria, on board SS Indarra on 26 November 1917 |
| Rank from Nominal Roll | Sapper |
| Unit from Nominal Roll | 1st Tunnelling Company |
| Fate | Returned to Australia 2 January 1919 |
